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Primary Mesenteric Undifferentiated Pleomorphic Sarcoma Masquerading as a Colon Carcinoma: A Case Report and Review of the Literature.

Diaz-Beveridge R, Melian M, Zac C, Navarro E, Akhoundova D, Chrivella M, Aparicio J - Case Rep Oncol Med (2015)

Bottom Line: By definition, in UPS, although the malignant cells tend to appear fibroblastic or myofibroblastic, they should not show differentiation towards a more specific line of differentiation.In this sense, we report the case of an 80-year-old patient with an initial clinical diagnosis of a locally advanced colonic neoplasm that was later confirmed as a primary mesenteric UPS.Primary mesenteric UPS are extremely rare with less than 20 cases reported.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Department, University Hospital La Fe, Avinguda de Fernando Abril Martorell, No. 106, 46026 Valencia, Spain.

ABSTRACT
Undifferentiated pleomorphic sarcoma (UPS) is the most common sarcoma that appears in older patients, usually in the extremities and the retroperitoneum. Other locations are rare. By definition, in UPS, although the malignant cells tend to appear fibroblastic or myofibroblastic, they should not show differentiation towards a more specific line of differentiation. In this sense, we report the case of an 80-year-old patient with an initial clinical diagnosis of a locally advanced colonic neoplasm that was later confirmed as a primary mesenteric UPS. Primary mesenteric UPS are extremely rare with less than 20 cases reported. We also review the pathologic and radiologic diagnostic criteria and the natural history of these tumours.

No MeSH data available.


Related in: MedlinePlus

Immunohistochemical analysis: The malignant cells show strong positivity to vimentin and focal patchy positivity to CD68, a nonspecific marker of fibrohistiocytic differentiation. S100 expression was negative.
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fig3: Immunohistochemical analysis: The malignant cells show strong positivity to vimentin and focal patchy positivity to CD68, a nonspecific marker of fibrohistiocytic differentiation. S100 expression was negative.

Mentions: The microscopic study revealed a poorly differentiated mesenchymal tumour, with ample zones of necrosis and with an extensive mononuclear inflammatory component. Some zones were abscessified. The malignant cells formed different morphological patterns, from highly cellular epithelioid areas to pleomorphic-storiform areas (Figure 2). Although some mucin could be seen, no typical lipoblasts were evident. The malignant cells were large, with highly atypical nuclei and microvacuolated cytoplasm. The immunohistochemical studies performed only showed a high positivity to vimentin and focal positivity to CD68 (Figure 3). Epithelial (cytokeratin and epithelial membrane antigen (EMA)), melanoma (S100 and HMB45), lymphoid (CD34), and neurogenic and myogenic markers (myogenin, actin, and desmin) expression were all negative. The study of both synovial sarcoma and Ewing sarcoma-specific translocations was negative. The final diagnosis was a primary mesenteric undifferentiated pleomorphic sarcoma with inflammation associated with a secondary obstructive endophytic colonic mass.


Primary Mesenteric Undifferentiated Pleomorphic Sarcoma Masquerading as a Colon Carcinoma: A Case Report and Review of the Literature.

Diaz-Beveridge R, Melian M, Zac C, Navarro E, Akhoundova D, Chrivella M, Aparicio J - Case Rep Oncol Med (2015)

Immunohistochemical analysis: The malignant cells show strong positivity to vimentin and focal patchy positivity to CD68, a nonspecific marker of fibrohistiocytic differentiation. S100 expression was negative.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4563063&req=5

fig3: Immunohistochemical analysis: The malignant cells show strong positivity to vimentin and focal patchy positivity to CD68, a nonspecific marker of fibrohistiocytic differentiation. S100 expression was negative.
Mentions: The microscopic study revealed a poorly differentiated mesenchymal tumour, with ample zones of necrosis and with an extensive mononuclear inflammatory component. Some zones were abscessified. The malignant cells formed different morphological patterns, from highly cellular epithelioid areas to pleomorphic-storiform areas (Figure 2). Although some mucin could be seen, no typical lipoblasts were evident. The malignant cells were large, with highly atypical nuclei and microvacuolated cytoplasm. The immunohistochemical studies performed only showed a high positivity to vimentin and focal positivity to CD68 (Figure 3). Epithelial (cytokeratin and epithelial membrane antigen (EMA)), melanoma (S100 and HMB45), lymphoid (CD34), and neurogenic and myogenic markers (myogenin, actin, and desmin) expression were all negative. The study of both synovial sarcoma and Ewing sarcoma-specific translocations was negative. The final diagnosis was a primary mesenteric undifferentiated pleomorphic sarcoma with inflammation associated with a secondary obstructive endophytic colonic mass.

Bottom Line: By definition, in UPS, although the malignant cells tend to appear fibroblastic or myofibroblastic, they should not show differentiation towards a more specific line of differentiation.In this sense, we report the case of an 80-year-old patient with an initial clinical diagnosis of a locally advanced colonic neoplasm that was later confirmed as a primary mesenteric UPS.Primary mesenteric UPS are extremely rare with less than 20 cases reported.

View Article: PubMed Central - PubMed

Affiliation: Medical Oncology Department, University Hospital La Fe, Avinguda de Fernando Abril Martorell, No. 106, 46026 Valencia, Spain.

ABSTRACT
Undifferentiated pleomorphic sarcoma (UPS) is the most common sarcoma that appears in older patients, usually in the extremities and the retroperitoneum. Other locations are rare. By definition, in UPS, although the malignant cells tend to appear fibroblastic or myofibroblastic, they should not show differentiation towards a more specific line of differentiation. In this sense, we report the case of an 80-year-old patient with an initial clinical diagnosis of a locally advanced colonic neoplasm that was later confirmed as a primary mesenteric UPS. Primary mesenteric UPS are extremely rare with less than 20 cases reported. We also review the pathologic and radiologic diagnostic criteria and the natural history of these tumours.

No MeSH data available.


Related in: MedlinePlus