Case Report: An exceptional response to neoadjuvant radiotherapy and chemotherapy in undifferentiated pleomorphic sarcoma following checkpoint inhibitor use

Figures

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  Figure 1. Pathology slides of the left chest wall mass. (A) Outside pathology slide diagnosed as poorly differentiated, high-grade spindle cell malignancy; (B) Outside pathology slide demonstrating focal, questionable positivity for HMB-45, initially leading to the diagnosis of melanoma; (C) Diffuse sheets of malignant cells diagnosed as high-grade malignant neoplasm at our institution; and (D) Multiple mitotic figures seen at our institution.

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  Figure 2. Baseline and interval imaging of the UPS of the chest wall. (A) PET CT on Month 0 showing the 16 cm invasive left axillary mass with FDG avidity and an indeterminate 5 mm pulmonary module; (B) CT angiography of the chest on Month 3 showing significant improvement in size of the left axillary chest wall mass at 10.2 cm with a stable 5 mm pulmonary nodule; and (C) CT of the chest on Month 8 showing stable post-surgical findings after extremity amputation without evidence of recurrent disease.

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  Figure 3. Timeline of events and interval images of the chest wall lesion. (A) Anterior view of the left fungating chest wall mass (image from Month 1), (B) Posterior view after left forequarter amputation and skin/muscle flaps (image from Month 11), and (C) Posterolateral view on routine follow-up visit (Month 29).