Presented by Dr. Ezra Baraban and prepared by Dr. Harsimar Kaur
Adult male with shoulder mass.
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Adult male with shoulder mass.
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Sections show a spindle cell neoplasm infiltrating deep dermis and subcutis. Nodular fasciitis may involve the dermis but necrosis and fascicular architecture are not typical. A myofibroblastic immunophenotype would be expected and demonstration of a USP6 rearrangement can be used to support the diagnosis. Melanoma can be excluded with negativity for S100 and SOX10 as well as the lack of an overlying in-situ component. Angiosarcoma should label with at least two of the three endothelial markers CD31, ERG, or CD34. This patient had a history of squamous carcinoma at this site. A previous biopsy with similar morphology showed extensive expression of multiple keratins and P40, confirming the diagnosis of sarcomatoid squamous cell carcinoma.
Incorrect
Sections show a spindle cell neoplasm infiltrating deep dermis and subcutis. Nodular fasciitis may involve the dermis but necrosis and fascicular architecture are not typical. A myofibroblastic immunophenotype would be expected and demonstration of a USP6 rearrangement can be used to support the diagnosis. Melanoma can be excluded with negativity for S100 and SOX10 as well as the lack of an overlying in-situ component. Angiosarcoma should label with at least two of the three endothelial markers CD31, ERG, or CD34. This patient had a history of squamous carcinoma at this site. A previous biopsy with similar morphology showed extensive expression of multiple keratins and P40, confirming the diagnosis of sarcomatoid squamous cell carcinoma.
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