GATA‐3 expression in a de‐differentiated chondrosarcoma with cutaneous iatrogenic implantation: a diagnostic pitfall with important clinical implications

Abstract

De‐differentiated chondrosarcoma (DDCS) is an extremely aggressive tumor of the bone characterized by a high‐grade, non‐chondroid sarcoma adjacent to a low‐ or intermediate‐grade chondrosarcoma. Adequate tumor sampling demonstrating the biphasic features is necessary to make an accurate diagnosis. The diagnosis may be challenging as histopathology may mimic other neoplasms. We present a case of a 76‐year‐old woman with a history of breast cancer who presented with a pathologic non‐displaced fracture. A bone biopsy demonstrated a high‐grade neoplasm composed of pleomorphic spindled and epithelioid cells with focal expression of AE1/3 and GATA3, most likely consistent with metastatic breast carcinoma. After a difficult clinical course, the tumor was resected demonstrating a similar morphology to her prior biopsy, as well as an area of a low‐grade cartilaginous neoplasm consistent with chondrosarcoma. The biphasic tumor alongside a low‐grade chondrosarcoma allowed for a diagnosis of DDCS. Several days after her procedure, the patient developed violaceous nodules overlying and surrounding the surgical site. Skin biopsy demonstrated a malignant epithelioid neoplasm with identical histomorphologic features identical to her prior bone resection. Given the location of the skin lesions directly within the surgical site right after resection, the clinical‐pathological picture was that of sarcomatosis cutis by iatrogenic cutaneous implantation.

A Case of GATA3 Positive Pleomorphic Liposarcoma, Epithelioid Variant: A Diagnostic Pitfall

“…Expression of GATA3 in nonepithelial tumors is limited and is considered diagnostically useful only for paraganglioma and malignant mesothelioma (sarcomatoid type) [10][11][12]. Only a few cases of aggressive sarcomas, such as dedifferentiated chondrosarcoma or angiosarcoma, leiomyosarcoma, and malignant melanoma, have been reported with GATA3 expression [8,13,14]. To the best of our knowledge, GATA3 expression in pleomorphic liposarcomas has not been previously reported.…”

A Rare Case of Myxochondroid Metaplasia of the Plantar Foot With Review of Histopathological Mimics

“…These are typically characterized by cytologic atypia and mitotic activity. [1][2][3] Metastatic chordomas are rare and are characterized by multivacuolated physaliphorous cells and keratin reactivity. 23 Ossifying fibromyxoid tumor can conceivably be considered in the histopathologic differential diagnosis because cartilaginous differentiation has been rarely reported in these tumors.…”

“…This is partly due to their rarity and broad biologic spectrum. [1][2][3][4] Correct classification is critical because the differential diagnosis includes highly malignant neoplasms and treatment varies significantly. Myxochondroid metaplasia of the plantar foot, which has been rarely reported in the English literature, enters this differential diagnosis because it usually presents in the dermis and superficial subcutis.…”