Proximal-type epithelioid sarcoma - Case report
In 2009, a 25-year-old man was referred to the dermatology department with a 3-month history of a rapidly growing painful mass on his right buttock which subsequently ulcerated. Skin examination revealed an erythematous infiltrated plaque and an ulcerated lesion with fibrinous exudate in the gluteal region (). There were no lymphadenopathies or other abnormalities on physical examination. A skin biopsy of the ulcerated lesion revealed proliferation of pleomorphic epithelioid cells with eosinophilic cytoplasm and vesicular nuclei with prominent nucleoli. Scattered rhabdoid cells characterized by abundant glassy cytoplasm, eccentric nuclei and prominent nucleoli were observed throughout the lesion (). Immunohistochemistry showed positivity for vimentin, cytokeratin, EMA, CAM 5.2, MIB and CD34 for the latter marker positivity was focal confirming the diagnosis of proximal-type epithelioid sarcoma (). Blood count and serum biochemistry were unremarkable, and culture for mycobacteria, fungi and aerobic bacteria were negative. At the time of diagnosis, the tests to define clinical staging, which included a computed tomography scan, revealed numerous metastatic lesions in the brain and lungs (). The patient received chemotherapy at a reference oncology institute but died in the ninth month of follow-up.