Multiple subcutaneous induration of the forearm.

概要

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The patient was a 32-year old housewife, noticed a few symptomless small nodules on her left wrist in October 1992. They gradually increased their size and number, Her past history revealed that her left middle finger was amputated in April 1992, due to progressive ischemia. Biopsy specimen of the nodule showed that there were irregular foci of collagen degeneration with mucin in the dermis, surrounded by spindle cells. A few mitotic figures were observed among them. These findings were quite similar to those observed in granuloma annulare. But, both cytological atypia and infiltrative pattern of the spindle cells into the peripheral nerve suggested us that this case represented an epithelioid sarcoma. Her left arm was amputated. Pathological studies showed an epithelioid sarcoma of the hand with multiple metastases to the skin. Axillary lymph nodes were also involved. Clinicians as well as pathologists should be aware that epithelioid sarcoma sometimes masquerades as a benign granulomatous disease.
日本皮膚悪性腫瘍学会の論文