Presentation
Chest pain, cough and haemoptysis. Resection of finger lesion a few years ago histologically identified as "inflammatory pseudotumour".
Patient Data
Multiple cystic lesions accompanied by ill-defined nodules and a dominant solid mass in the right upper lobe. Peri-lesional ground-glass changes are demonstrated. Small left-sided pneumothorax.
Findings are consistent with cystic and solid haemorrhagic pulmonary metastases, complicated by pneumothorax.
Biopsy revealed epithelioid sarcoma metastases.
Case Discussion
Epithelioid sarcoma is a rare soft tissue tumour with unclear histogenesis that represents the most common soft tissue sarcoma of a hand. This tumour is often mistaken for a chronic inflammatory process or necrotising granuloma due to its innocuous presentation as well as unusual both epithelial and mesenchymal differentiation (immunohistochemistry stains were positive for vimentin and cytokeratin 8). Epithelioid sarcoma has known propensity for pulmonary metastases, which can present as cystic lesions and be complicated by the development of pneumothorax and haemorrhage.
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