Eaton Kyle W, Jagenburg Emily, Pakray Arian, Kinni Vikram, Pomerantz Benjamin
Diagnostic Radiology, Henry Ford Health System, Southfield, USA.
Radiology, Oakland University William Beaumont School of Medicine, Rochester, USA.
Cureus. 2025 Jun 11;17(6):e85786. doi: 10.7759/cureus.85786. eCollection 2025 Jun.
A 43-year-old male patient presented with a progressively enlarging mass in his right lateral tibia over the course of one month. The mass measured 4 x 7 cm in size on examination. Aspiration of the lesion was performed, revealing 30 cc of dark blood, leading to an initial diagnosis of hematoma. Three months later, the mass had enlarged with mild pain. Physical examination revealed a 12 x 9 cm fluctuant mass on the right lateral lower leg, which was warmer than surrounding skin and tender upon palpation. Subsequent imaging was ambiguous, with a broad differential diagnosis consisting of expanding hematoma, abscess, neoplasm, and arteriovenous malformation (AVM). A biopsy was performed revealing pleomorphic cells consistent with an undifferentiated pleomorphic sarcoma (UPS). This case report highlights the challenges of diagnostic workup, management, and follow-up of an unusual presentation of a UPS.
一名43岁男性患者在一个月内右侧胫骨外侧出现逐渐增大的肿块。检查时肿块大小为4×7厘米。对病变进行了穿刺，抽出30毫升暗红色血液，初步诊断为血肿。三个月后，肿块增大并伴有轻度疼痛。体格检查发现右下肢外侧有一个12×9厘米的波动肿块，比周围皮肤温度高，触诊时有压痛。随后的影像学检查结果不明确，鉴别诊断范围广泛，包括扩大的血肿、脓肿、肿瘤和动静脉畸形（AVM）。活检显示多形性细胞，符合未分化多形性肉瘤（UPS）。本病例报告强调了UPS不寻常表现的诊断检查、管理和随访的挑战。
