Clear cell sarcoma of the right lumbar region: A case report and review of the literature

Abstract

Clear cell sarcoma of soft tissues is a very rare, malignant soft tissue tumor that usually arises in the extremities, with a predilection for the lower limbs. This report presents a 45-year-old male with a painless mass in the right lumbar region for one year. Magnetic resonance imaging showed a 3.6×3.2×1.5-cm soft tissue mass of the right lumbar region. The tumoral cells had pleomorphic nuclei and large amounts of clear cytoplasm, and a proportion of the cells contained melanin. Immunohistochemical analysis was performed, which identified that the cells were positive for S-100, MITF and HMB-45 tumor markers. The patient underwent a postoperative chemotherapy protocol and had no local recurrences at one year post-surgery.

Clear cell sarcoma

“…The local recurrence of the disease is not associated with worse prognosis [7], which corresponds to the theory posited by Lewis et al [75], saying that mortality in sarcomas located on the limbs is caused by distant metastases and not local recurrence of the disease. Pre-operative duration of symptoms, mitotic index, or vascular invasion do not correlate with the survival time in these patients [16].…”

“…Although most frequent localization of distant dissemination of CCS is the lung, nevertheless numerous metastases to the skin, bones, liver, heart, and brain have also been described [14][15][16]. Generally, CCS is an aggressive tumour with a tendency of relapse, early metastasis development, and therefore short overall survival (OS) [9].…”