Publication: CD34-positive myxoid sarcoma of the retroperitoneum; a dilemma in differential diagnosis of multiple biopsy specimens
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Date
2010
Authors
Terada, Tadashi
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
The author reports a case of CD34-positive
malignant myxoid sarcoma in the retroperitoneum with a
dilemma of differential diagnosis in multiple biopsy
specimens of different locations. A 79-year-old man was
diagnosed with right renal pelvic carcinoma and
nephrectomy was performed. The carcinoma was
urothelial carcinoma (2cm in diameter) without invasion.
The patient was followed up, and a large retroperitoneal
tumor was found two years after the operation. Multiple
needle biopsies were performed. The patient then
showed a hepatic metastasis, and died of cachexia one
year after the detection of the retroperitoneal tumor. The
needle biopsy specimens showed spindle cell sarcoma in
the myxomatous stroma (80%) and in the nonmyxomatous
stroma (20%). Immunohistochemically, the
tumor cells were positive for vimentin, CD34, CD99,
bcl-2 and p53 protein. They were negative for
cytokeratins, desmin, α-smooth muscle actin, S100
protein, melanosome, CEA, neuron specific enolase,
CD68, factor VIII-related antigen, CD31, KIT, and
PDGFRA. Ki67 labeling was 30%. A genetic analysis
for KIT gene (exons 9, 11, 13 and 17) and PDGFRA
gene (exons 12 and 18) showed no mutations. Although
the differential diagnosis is problematic and difficult, the
present case is probably dedifferentiated liposarcoma.
The needle biopsy diagnosis of sarcomas is difficult and
limited because sarcomas show heterogenous histologies
with regard to locations in the same tumor.
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