An important case of misdiagnosis: keloid scar or high-grade soft-tissue sarcoma?

Nicholas, Rebecca; Stodell, Matthew

doi:10.1136/bcr-2014-203600

Cited by 6 publications

(6 citation statements)

References 3 publications

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“…The amplification of c-myc oncogene is probably responsible for its aggressive biological behavior [20,21]. There are still too many errors in initial management, as was the case for our patient, who is nevertheless a crucial and well-documented case [9], which can lead to a significant loss of opportunity for patients [22][23][24][25].…”

Section: Discussionmentioning

confidence: 89%

Elbow flexion reconstruction after arm-sparing excision for high-grade triton sarcoma: a case report

et al. 2020

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Background: Soft tissue sarcomas affecting the root of an upper extremity raise the question of limb amputation depending on their location, size, and malignancy. Malignant triton tumors are a rare subtype of neurofibrosarcomas that have been poorly reported in the literature. We report the case of a challenging reconstruction of the upper extremity using a pedicled latissimus dorsal flap. Case presentation: A 25-year-old Occidental man was referred to our sarcoma unit for the management of a large, high-grade malignant peripheral nerve sheath tumor with no regional or distant extension and very fast progression. He was treated first by concomitant neoadjuvant radiotherapy and chemotherapy. Carcinologic excision was performed "en bloc" including the skin, the tumor, and the flexor muscles of our patient's elbow. Coverage of the skin defect and elbow flexion restoration were achieved by using a homolateral pedicled musculocutaneous latissimus dorsi flap. Histological analysis showed an R0 resection. The reconstruction process recovered a complete bending of his elbow. He is still in remission at 26 months follow-up. Conclusions: A malignant triton tumor is a rare, aggressive, and high-grade sarcoma. It was successfully treated and this case report describes an effective treatment modality. Reconstructive surgery, allowing large, complete tumor removal, is indispensable after neoadjuvant chemotherapy and radiotherapy.

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Section: Discussionmentioning

confidence: 89%

Elbow flexion reconstruction after arm-sparing excision for high-grade triton sarcoma: a case report

et al. 2020

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“…There had been previous case reports misdiagnosing sarcoma for keloid scars. 10 In this case, previous CABG made it even more challenging. It was reported by the previous care giver that initially the tumor mimicked post CABG keloid.…”

Section: Discussionmentioning

confidence: 91%

“…Once diagnosed, reports suggested that the standard of care for ES patients is surgical resection with negative margins. 10 However, (due to its rarity) strong statistical evidences on the benefit of intraoperative surgical lymph node inspection and post-operative radiation are yet to be published.…”

Section: Introductionmentioning

confidence: 99%

Sternal reconstruction for primary sternal tumor in a post-coronary artery bypass grafting surgery patient

Romolo

Andinata

Aisiyah

et al. 2019

SAGE Open Medical Case Reports

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Epithelioid sarcoma is a very rare tumor, comprising less than 1% of all soft tissue sarcoma. Due to its rarity and benign presentation, it is often misdiagnosed. We present a case of epithelioid sarcoma mimicking coronary artery bypass grafting post-operative keloid. Current literature suggests the management for epithelioid sarcoma to include surgery and adjuvant radiation. In this patient, chest wall reconstruction was done using titanium mesh and muscle flaps. Post-operative radiation was given and computerized tomography scan was evaluated 3 months after reconstruction.

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“…Therefore, the aim here was to identify a molecular diagnostic biomarker capable of distinguishing KS from other forms of dermal scarring specially HTS and also dermatofibrosarcoma protuberans (DFSPs)-an uncommon progressive, reticular dermal neoplasm with high recurrence. Often, keloid and/or DFSP are misdiagnosed (Kimura et al, 2014, Nguyen et al, 2002, Nicholas and Stodell, 2014, Suarez et al, 2015. We have demonstrated immune upregulation and the presence of lymphoid aggregates while investigating the presence of plasma cells in 63 KS tissue samples (Bagabir et al, 2012) using immunohistochemistry, and serendipity that led to the identification of abundant expression of CD138 in KS.…”

Section: To the Editormentioning

confidence: 88%

Identification of a Potential Molecular Diagnostic Biomarker in Keloid Disease: Syndecan-1 (CD138) Is Overexpressed in Keloid Scar Tissue

Bagabir

Syed

Shenjere

et al. 2016

Journal of Investigative Dermatology

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first year that cutaneous warts on the hands were assessed, were included in this analysis (Melski et al., 1977; Stern et al., 1979). The Mann-Whitney (Wilcoxon) twosample test for medians and Student t test for means were used to test for statistical significant differences between groups. Poisson regression was used to calculate the association of developing subsequent SCCs or BCCs with the presence of cutaneous hand warts in 1985e1986 and other risk factors. Age, sex, geographic location, and population incidence rates were used to calculate expected number of tumors (Scotto et al., 1974; Stern et al., 1979). We performed a univariate analysis of the association of cutaneous warts with previous history of SCC or BCC, level of exposure to PUVA up to the year 1985, high UVB exposure (300 treatments or more), high doses of methotrexate (if given for 36 or more months), and high doses of cyclosporine (if given for 2 or more years). Factors significant on univariate analysis were included in the multivariable model.

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An important case of misdiagnosis: keloid scar or high-grade soft-tissue sarcoma?

Cited by 6 publications

References 3 publications

Elbow flexion reconstruction after arm-sparing excision for high-grade triton sarcoma: a case report

Elbow flexion reconstruction after arm-sparing excision for high-grade triton sarcoma: a case report

Sternal reconstruction for primary sternal tumor in a post-coronary artery bypass grafting surgery patient

Identification of a Potential Molecular Diagnostic Biomarker in Keloid Disease: Syndecan-1 (CD138) Is Overexpressed in Keloid Scar Tissue

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