Ortoli J C, Mansouri S, Veron C, Servant J M, Marinho E, Aractingi S
Unité de Dermatologie, Hôpital Tenon, Paris.
Ann Dermatol Venereol. 1998 Mar;125(3):179-81.
Epitheloid sarcoma is an uncommon malignant soft tissue tumor observed in the distal extremities of young men. We report a case of long standing ulceration of the sole which was found to be an epithelioid sarcoma.
A 78-year-old woman had an indolent ulceration of the left sole for several months. Physical examination disclosed a well demarcated 3-cm ulcerated lesion with a red center and flat edges. Skin sections confirmed the diagnosis of epithelioid sarcoma. Cells stained positively for anti-vimentin, anti-cytokeratin and anti-epithelial membrane antigen, but not for anti-S100 protein and anti-actin antibodies. Wide local excision was performed.
Epithelioid sarcoma is an uncommon malignant tumor which apparently differentiates from mesenchymatous cells. It is usually observed in the distal extremities in young males, predominantly the hands and forearms. The tumor presents a firm, flesh-colored indolent nodule. Ulceration usually develops and involves the subcutis and deeper soft tissue, particularly fascial planes, aponeuroses and tendon sheaths. Treatment is wide surgical excision with or without radiotherapy. The case reported here on the sole of the foot in a 78-year-old women is unusual. Clinicians should be aware that the initial biopsy may not be contributive and that repeated biopsies may be necessary for positive diagnosis.
上皮样肉瘤是一种罕见的恶性软组织肿瘤，多见于年轻男性的四肢远端。我们报告一例足底长期溃疡，最终被诊断为上皮样肉瘤的病例。
一名78岁女性，左足底出现无痛性溃疡数月。体格检查发现一个边界清晰的3厘米溃疡病灶，中央发红，边缘扁平。皮肤切片确诊为上皮样肉瘤。细胞抗波形蛋白、抗细胞角蛋白和抗上皮膜抗原染色呈阳性，但抗S100蛋白和抗肌动蛋白抗体染色阴性。进行了广泛的局部切除。
上皮样肉瘤是一种罕见的恶性肿瘤，明显起源于间充质细胞。通常见于年轻男性的四肢远端，主要是手部和前臂。肿瘤表现为坚实的、肉色的无痛性结节。通常会发生溃疡，并累及皮下组织和更深层的软组织，尤其是筋膜平面、腱膜和腱鞘。治疗方法是广泛手术切除，可联合或不联合放疗。本文报告的78岁女性足底病例较为罕见。临床医生应意识到，初次活检可能无助于诊断，可能需要多次活检才能确诊。
