Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report

Undifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue sarcoma with a poor prognosis. The patients are usually found to have metastasis when the primary tumor is diagnosed. Eccrine syringofibroadenoma (ESFA) is a rare cutaneous adnexal lesion of eccrine duct origin. There are five s...

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Main Authors: Navinda Donsakul, Suthep Jerasutus, Ittipon Tubtieng, Ravion Assavanatenapa, Voraphol Vejjabhinanta
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Dermatopathology
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Online Access:https://www.mdpi.com/2296-3529/11/4/30
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author Navinda Donsakul
Suthep Jerasutus
Ittipon Tubtieng
Ravion Assavanatenapa
Voraphol Vejjabhinanta
author_facet Navinda Donsakul
Suthep Jerasutus
Ittipon Tubtieng
Ravion Assavanatenapa
Voraphol Vejjabhinanta
author_sort Navinda Donsakul
collection DOAJ
description Undifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue sarcoma with a poor prognosis. The patients are usually found to have metastasis when the primary tumor is diagnosed. Eccrine syringofibroadenoma (ESFA) is a rare cutaneous adnexal lesion of eccrine duct origin. There are five subtypes, one of which is reactive ESFA, known to occur in reaction to an inflammatory or neoplastic process. In this article, we report a case of the co-existence of both UPS and ESFA in a 70-year-old male patient, presenting with a painless, erythematous, irregular surface nodule with a peripherally extended brownish hyperkeratotic plaque on the right palm. The histologic findings revealed an ill-defined dermal tumor of atypical epithelioid and spindle-shaped cells with large pleomorphic hyperchromatic nuclei and abundant eosinophilic cytoplasm. Some of those cells were multinucleated giant cells in the stroma with vascular proliferation and mixed inflammatory cell infiltrate. The tumor cells, which were only positive for vimentin, supported the diagnosis of undifferentiated pleomorphic sarcoma (UPS). Meanwhile, the overlying epidermis demonstrated hyperkeratosis, papillated epidermal hyperplasia, and proliferation of anastomosing slender cords and strands of cuboid cells within loose fibrovascular stroma. These findings are the characteristics of eccrine syringofibroadenoma (ESFA). We describe here a patient in whom reactive ESFA occurred on and surrounded the UPS tumor.
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spelling doaj-art-c2d5fce77d1a475ea0a2e26ef85429062025-08-20T02:55:56ZengMDPI AGDermatopathology2296-35292024-10-0111428629210.3390/dermatopathology11040030Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case ReportNavinda Donsakul0Suthep Jerasutus1Ittipon Tubtieng2Ravion Assavanatenapa3Voraphol Vejjabhinanta4Southern Regional Hospital of Tropical Dermatology-Trang Province, Department of Medical Services, Ministry of Public Health, Trang 92000, ThailandDivision of Dermatology, Department of Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, ThailandPhatthalung Hospital, Phatthalung 93000, ThailandInstitute of Dermatology, Department of Medical Services, Ministry of Public Health, Bangkok 10400, ThailandSouthern Regional Hospital of Tropical Dermatology-Trang Province, Department of Medical Services, Ministry of Public Health, Trang 92000, ThailandUndifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue sarcoma with a poor prognosis. The patients are usually found to have metastasis when the primary tumor is diagnosed. Eccrine syringofibroadenoma (ESFA) is a rare cutaneous adnexal lesion of eccrine duct origin. There are five subtypes, one of which is reactive ESFA, known to occur in reaction to an inflammatory or neoplastic process. In this article, we report a case of the co-existence of both UPS and ESFA in a 70-year-old male patient, presenting with a painless, erythematous, irregular surface nodule with a peripherally extended brownish hyperkeratotic plaque on the right palm. The histologic findings revealed an ill-defined dermal tumor of atypical epithelioid and spindle-shaped cells with large pleomorphic hyperchromatic nuclei and abundant eosinophilic cytoplasm. Some of those cells were multinucleated giant cells in the stroma with vascular proliferation and mixed inflammatory cell infiltrate. The tumor cells, which were only positive for vimentin, supported the diagnosis of undifferentiated pleomorphic sarcoma (UPS). Meanwhile, the overlying epidermis demonstrated hyperkeratosis, papillated epidermal hyperplasia, and proliferation of anastomosing slender cords and strands of cuboid cells within loose fibrovascular stroma. These findings are the characteristics of eccrine syringofibroadenoma (ESFA). We describe here a patient in whom reactive ESFA occurred on and surrounded the UPS tumor.https://www.mdpi.com/2296-3529/11/4/30undifferentiated pleomorphic sarcomaeccrine syringofibroadenomamalignant fibrous histiocytomasoft tissue sarcoma
spellingShingle Navinda Donsakul
Suthep Jerasutus
Ittipon Tubtieng
Ravion Assavanatenapa
Voraphol Vejjabhinanta
Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report
Dermatopathology
undifferentiated pleomorphic sarcoma
eccrine syringofibroadenoma
malignant fibrous histiocytoma
soft tissue sarcoma
title Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report
title_full Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report
title_fullStr Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report
title_full_unstemmed Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report
title_short Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report
title_sort undifferentiated pleomorphic sarcoma with reactive eccrine syringofibroadenoma a case report
topic undifferentiated pleomorphic sarcoma
eccrine syringofibroadenoma
malignant fibrous histiocytoma
soft tissue sarcoma
url https://www.mdpi.com/2296-3529/11/4/30
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AT ravionassavanatenapa undifferentiatedpleomorphicsarcomawithreactiveeccrinesyringofibroadenomaacasereport
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