Epithelioid sarcoma originating in the chest wall: A case report

Area of Science:

• Oncology
• Pathology
• Surgical Oncology

Background:

• Epithelioid sarcoma (ES) is a rare soft tissue sarcoma.
• The chest wall is an unusual site for ES, posing diagnostic challenges.
• Accurate differentiation from other epithelioid neoplasms is crucial.

Purpose of the Study:

• To report the sixth case of chest wall epithelioid sarcoma.
• To highlight diagnostic considerations and immunohistochemical findings.
• To emphasize the importance of pre-decalcification tissue trimming for immunohistochemistry.

Main Methods:

• Case presentation of a 71-year-old male with incidentally diagnosed chest wall soft tissue tumor.
• Surgical resection and chest wall reconstruction.
• Histopathological examination and immunohistochemical analysis of tumor samples.

Main Results:

• Multinodular growth with collagenous stroma, mimicking granulomatous process.
• Tumor cells showed epithelioid, spindle, and rhabdoid morphology.
• Immunohistochemistry positive for AE1/AE3, vimentin, CD34; negative for CK7, CK20, CD31, calretinin, D2-40; INI1 negative.

Conclusions:

• Chest wall epithelioid sarcoma is rare and diagnostically challenging.
• Proper tissue handling, including pre-decalcification trimming, is vital for accurate immunohistochemical diagnosis.
• This case underscores the importance of comprehensive diagnostic workup for rare tumors.