Clear cell sarcoma of tendons and aponeuroses treated with bleomycin and vincristine

Clear cell sarcoma of tendons and aponeuroses is a rare tumour first described by Enzinger in 1965. A case is reported which responded to bleomycin and vincristine. Such a response has not previously been documented. The patient was a 30-year-old woman who first presented in June 1975 with painless lumps on her left leg. Seven years previously she had received a slight knock to her left shin and then noticed two firm lumps at the site. Two years before presentation the lumps had increased in size and there was a generalized swelling of the leg below the lumps. Her appetite had diminished and she had begun to lose weight and experience pain in her left knee and ankle. For the last six months the area around the lumps had become red and hairless. Five weeks before presentation a new lump had appeared below the first two. On examination she was found to have a mass over the upper third of her left tibia (Fig. 1.) measuring 10 × 8 cm with an ulcerated centre 3.5 × 2 cm and below this two further masses 4 × 3 cm and 1.5 × 1.5 cm. The masses were firm and appeared attached to the underlying bone. The left leg distal to the masses was swollen and oedematous so that the circumference of the left leg was 9 cm greater than the right measured at a point 10 cm below the patella.