Undifferentiated Pleomorphic Sarcoma
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Matthew J. Ferry
An 86-year-old man presented with an ulcerated plaque on the right antihelix that had been present for several months (image A). Superficial biopsy revealed an atypical spindle cell proliferation, consistent with an atypical fibroxanthoma (AFX). Mohs surgery was performed, and histopathologic analysis showed uniform atypical spindle cells in a storiform pattern filling the dermis to the subcutis, suggesting the diagnosis of an undifferentiated pleomorphic sarcoma (UPS) (image B).
AFXs are uncommon cutaneous neoplasms of pleomorphic myofibroblast-like cells.1 Whether these lesions represent keratin-positive dermal sarcomas or poorly differentiated carcinomas is debatable. Diagnosis requires exclusion of other undifferentiated spindle and pleomorphic cell neoplasms, such as UPSs, by immunohistochemical analysis.2 These soft tissue tumors present with AFX-like clinical and pathologic findings, but have higher-grade histologic features with greater rates of local recurrence and metastasis.2 While evidence indicates that these neoplasms lie on the same clinicopathologic spectrum, diagnostic criteria separating the 2 remains ill-defined.2 Consequently, clinical experience suggests that such cases should be managed promptly and treated aggressively. Despite clear margins, the tumor recurred in the patient and, ultimately, metastasized.
References
1. MahalingamS, ShahA, StewartA. Atypical fibroxanthoma: a case series and review of literature. Auris Nasus Larynx. 2015;42(6):469-471. doi:10.1016/j.anl.2015.04.001Suche in Google Scholar PubMed
2. SoleymaniT, AasiSZ, NovoaR, HollmigST. Atypical fibroxanthoma and pleomorphic dermal sarcoma: updates on classification and management. Dermatol Clin. 2019;37(3):253-259. doi:10.1016/j.det.2019.02.001Suche in Google Scholar PubMed
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Artikel in diesem Heft
- LETTERS TO THE EDITOR
- Osteopathic Response to the COVID-19 Pandemic
- EDITORIAL
- Research at University of New England College of Osteopathic Medicine
- ORIGINAL CONTRIBUTION
- Life vs Loans: Does Debt Affect Career Satisfaction in Osteopathic Graduates?
- BRIEF REPORT
- Eosinopenia and COVID-19
- JAOA/AACOM MEDICAL EDUCATION
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- Making the Connection: Using Concept Mapping to Bring the Basic Sciences to the Diagnosis
- Report on 7 Years’ Experience Implementing an Undergraduate Medical Curriculum for Osteopathic Medical Students Using Entrustable Professional Activities
- SPECIAL COMMUNICATION
- Forty Years of University of New England's Research and Scholarship and its Impact in Maine, New England, and Beyond
- CLINICAL IMAGES
- Undifferentiated Pleomorphic Sarcoma
Artikel in diesem Heft
- LETTERS TO THE EDITOR
- Osteopathic Response to the COVID-19 Pandemic
- EDITORIAL
- Research at University of New England College of Osteopathic Medicine
- ORIGINAL CONTRIBUTION
- Life vs Loans: Does Debt Affect Career Satisfaction in Osteopathic Graduates?
- BRIEF REPORT
- Eosinopenia and COVID-19
- JAOA/AACOM MEDICAL EDUCATION
- Learning Together: Interprofessional Education at the University of New England
- 48-Hour Hospice Home Immersion Encourages Osteopathic Medical Students to Broaden Their Views on Dying and Death
- Making the Connection: Using Concept Mapping to Bring the Basic Sciences to the Diagnosis
- Report on 7 Years’ Experience Implementing an Undergraduate Medical Curriculum for Osteopathic Medical Students Using Entrustable Professional Activities
- SPECIAL COMMUNICATION
- Forty Years of University of New England's Research and Scholarship and its Impact in Maine, New England, and Beyond
- CLINICAL IMAGES
- Undifferentiated Pleomorphic Sarcoma
