A clinicopathologic study of six cases of epithelioid sarcoma.

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Epithelioid sarcoma is an unusual soft tissue neoplasm with distinct morphologic and clinical evolution, but has been confused with a variety of other benign and malignant lesions. Epithelioid sarcoma is most often found in young adult males as a subfascial or subcutaneous lesion originating on the limbs. At an early stage of the tumor, it appears as a solitary nodular lesion (nodular type), however, in longstanding cases, it is manifested as a firm area of induration or a multinodular lumpy mass (invasive type).The age of the patients at the time of initial surgery were 8, 18, 21, 26, 35 and 61 years respectively, with a median of 28 years. There were four males and two females. The patients had had symptoms for five months to six years before the initial treatment. Four cases were invasive type and two nodular type. In two of these patients the tumor was removed initially by wide local excision, but the involved limb was subsequently amputated because of local recurrences. Three cases were treated solely by wide local excision. One case was treated by disarticulation of the affected thumb at the initial surgery. Only one case (nodular type) treated by wide local excision is free of disease for nine years and six months. Five had metastases to the skin of the more proximal portions of the same extremity and or the draining lymph nodes.In conclusion, the case of invasive type should be treated by amputation from the beginning, because of difficulty of evaluation of curative surgical margin, and wide local excision may be effective in case of nodular type.
西日本整形・災害外科学会の論文

A clinicopathologic study of six cases of epithelioid sarcoma.

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