Key result
A 31-year-old female with a non-healing burn ulcer was diagnosed with a rare angiomatoid variant of epithelioid sarcoma, which mimics epithelioid vascular neoplasms.
Why the study?
Epithelioid sarcoma is a rare and aggressive soft tissue sarcoma that presents a significant diagnostic and management challenge to clinicians.
Case Report (n=1)
Loss of SMARCB1/INI1 expression is a key pathological characteristic that distinguishes angiomatoid epithelioid sarcoma from epithelioid vascular neoplasms.
May warrant considering angiomatoid epithelioid sarcoma in non-healing burn ulcers mimicking vascular tumors; leaves open need for additional cases to guide practice.
Epithelioid sarcoma is a rare but aggressive soft tissue sarcoma that presents a significant diagnostic and management challenge to clinicians. We report a 31-year-old female who presented with a non-healing ulcer of three years’ duration on her left thumb after a burn. Examination revealed an ulcerative tumour invading the bone with areas of haemorrhage. Microscopic examination showed an epithelioid neoplasm with central necrosis. The neoplastic cells formed dyscohesive sheets, slit-like channels, and pseudovascular spaces. Erythrocytes were frequently observed in these areas. The neoplastic malignant cells were diffusely positive for cytokeratin AE1/AE3, EMA, vimentin, Fli-1; while focally positive for CD34 and CD31. The morphology and immunophenotype overlap with a vascular neoplasm. Additional immunohistochemical stain revealed loss of SMARCB1/INI1 expression supporting the diagnosis of epithelioid sarcoma of distal type, angiomatoid variant. We present a distinctive case of angiomatoid epithelioid sarcoma that developed in a burn ulcer and highlight pathological characteristics that distinguish it from epithelioid vascular neoplasms.
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Lai et al. (2022) conducted a case report in Angiomatoid Epithelioid Sarcoma (n=1). Amputation and chemotherapy was evaluated. A 31-year-old female with a non-healing burn ulcer was diagnosed with a rare angiomatoid variant of epithelioid sarcoma, which mimics epithelioid vascular neoplasms.
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