Dermatológia pre prax 2/2018
Pleomorfný nediferencovaný sarkóm mäkkých tkanív – kazuistika
Pleomorphic undifferentiated sarcoma of the soft tissue – a case report Background: Soft tissue sarcomas represent a very heterogeneous group of tumors. Histogenetically, they are divided into two categories: the sarcomas with a specific line of differentiation and a subset of undifferentiated sarcomas, in which it is not possible to reliably identify a tissue, from which they originate. Case report: The authors describe a 64–year old man with a progressively growing subcutaneous tumor on the chest. The tumor grew approximately for 6 months and it reached 15 cm in size. Microscopy revealed a high-grade sarcoma predominantly consisted of the pleomorphic and spindle cell population. It was immunohistochemically positive for vimentin and CD68, focally positive for smooth muscle actin, and sporadically positive for h-caldesmon. Polyclonal cytokeratins, desmin, CD34 and S-100 protein were negative. Based on histomorphology and imunophenotype, the pathologist established a diagnosis of pleomorphic undifferentiated sarcoma. Subsequent imaging exams detected tumor metastases in the lungs. Patient died 8 months after diagnosis has been done. Conclusion: Although the category of undifferentiated sarcomas comprises a notable percentage among all soft tissue sarcomas, it is not a separate nosological entity. It is highly probable, an expansion of investigative methods in pathology will lead to their exact subclassification and this diagnosis of exclusion will be used more rarely.
Keywords: soft tissue sarcomas, undifferentiated pleomorphic sarcoma
