Epithelioid sarcoma pulmonary metastases
Chest pain, cough and haemoptysis. Previous resection of finger lesion few years ago then histologically identified as "inflammatory pseudotumor".
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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 consistent with cystic and solid hemorrhagic pulmonary metastases, complicated by pneumothorax.
Biopsy revealed epithelioid sarcoma metastases.
Epithelioid sarcoma is a rare soft tissue tumor with unclear histogenesis that represents the most common soft tissue sarcoma of a hand. This tumor is often mistaken for a chronic inflammatory process or necrotizing granuloma due to its innocuous presentation as well as unusual both epithelial and mesenchymal diffirentiation (vimentin and cytokeratin 8 IHC stains were positive). Epithelioid sarcoma has known propensity for pulmonary metastases, which can present as cystic lesions and be complicated by development of pneumothorax and hemorrhage.
- de Visscher SA, van Ginkel RJ, Wobbes T et-al. Epithelioid sarcoma: Still an only surgically curable disease. Cancer. 2006;107 (3): 606-12. doi:10.1002/cncr.22037 - Pubmed citation
- Sobanko JF, Meijer L, Nigra TP. Epithelioid Sarcoma: A Review and Update. Jerry T, Sanjay B, Joshua Z, eds. The Journal of Clinical and Aesthetic Dermatology. 2009;2(5):49-54. Pubmed article