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Case of the Month



Undifferentiated Pleomorphic Sarcoma

40 year old male presented with a right hip mass. Biopsy of the mass showed a highly cellular neoplasm consisting of epithelioid cells admixed with numerous multinucleated giant cells. Mitotic figures, including atypical forms, are readily identified. Focal tumor necrosis is also present. Immunoperoxidase stains show that the tumor cells stain positive with CD68 and Vimentin. No staining is seen with CK-Pan, Cam 5.2, SMA, S100, ERG, and CD34 stains. The diagnosis is Giant Cell Variant of Undifferentiated Pleomorphic Sarcoma.

Undifferentiated pleomorphic sarcoma is the most common soft tissue sarcoma occurring in deep connective tissue of the extremities, abdominal cavity, and retroperitoneum of middle/late adulthood. Adverse prognostic factors include large tumor, distant metastasis, and older age. The five year survival is 50-60%.