Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report

Area of Science:

• Dermatopathology
• Oncology

Background:

• Undifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue malignancy with a typically poor prognosis, often presenting with metastasis.
• Eccrine syringofibroadenoma (ESFA) is a rare benign adnexal neoplasm, with reactive subtypes known to arise secondary to other processes.

Observation:

• A 70-year-old male presented with a right palm lesion exhibiting features of both UPS and ESFA.
• Histopathological examination revealed a dermal tumor consistent with UPS, characterized by atypical pleomorphic cells positive for vimentin.
• The overlying epidermis showed changes diagnostic of ESFA, including hyperkeratosis and epidermal hyperplasia.

Findings:

• The study documents the simultaneous presence of undifferentiated pleomorphic sarcoma and reactive eccrine syringofibroadenoma in a single patient.
• Histologic analysis confirmed UPS by atypical cellular morphology and vimentin positivity.
• The ESFA findings, including epidermal hyperplasia and specific ductal proliferation, were observed in the epidermis overlying the UPS.

Implications:

• This case expands the understanding of reactive ESFA, suggesting it can occur in association with aggressive sarcomas.
• The co-existence of these distinct entities presents diagnostic challenges and may influence treatment strategies for soft tissue tumors.
• Further research is warranted to explore the pathogenetic mechanisms linking UPS and reactive ESFA.