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Intramuscular Epithelioid Sarcoma Presenting as Extrinsic Flexor Tightness in the Forearm
Yuji Tomori1, Ryuji Ohashi2, Takuya Sawaizumi1
1Department of Orthopedic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
The Journal of Hand Surgery
|April 1, 2018
Summary
Epithelioid sarcoma, a rare soft tissue cancer, often affects young adults. Delayed diagnosis can occur due to subtle symptoms like wrist tightness, highlighting the need for accurate histological evaluation.
Area of Science:
- Oncology
- Pathology
- Orthopedics
Background:
- Epithelioid sarcoma is a rare soft tissue malignancy.
- It predominantly affects adolescents and young adults in distal extremities.
- Early diagnosis and treatment are challenging due to its rarity and subtle presentation.
Observation:
- A 37-year-old male presented with wrist and finger flexor tightness.
- Initial assessment suggested inflamed soft tissue causing contracture.
- Symptoms mimicked common conditions, delaying definitive diagnosis.
Findings:
- Histological examination of a biopsy specimen was crucial.
- Revealed nodular proliferation of epithelioid and spindle cells.
- Immunoreactivity to both epithelial and nonepithelial markers confirmed the diagnosis.
Implications:
- Accurate histological and immunohistochemical analysis is vital for diagnosing epithelioid sarcoma.
- Highlights the importance of considering rare diagnoses in cases of unexplained soft tissue symptoms.
- Emphasizes the need for increased awareness among clinicians for timely intervention.
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