Onkologie. 2025:19(1):42-45 | DOI: 10.36290/xon.2025.010

Pleomorphic dermal sarcoma

Vladimír Bartoš¹, Dagmar Hurtová²

¹ Martinské bioptické centrum, s. r. o., Martin, Slovenská republika

² Dermatovenerologická ambulancia, Púchov, Slovenská republika

Introduction: Pleomorphic dermal sarcoma (PDS) is a rare malignant mesenchymal tumor of the skin. It clinically and histogenetically shares similar features with atypical fibroxanthoma (AFX) and they are thought to represent the morphologic spectrum of one neoplasia.

Case report: A 60-year-old man with a history of vocal cord carcinoma had observed an ulcerated skin tumor in the scalp growing for several months. It was removed by surgical excision. Histology revealed a solid mesenchymal tumor consisting of atypical cells population of epithelioid and histiocytoid appearance. At the base, it infiltrated the subcutaneous fat and extended into the deep fascia. A blood vessel filled with a tumor thrombus was found. The tumor was positive for CD68, CD10, CD163, CD99 and partly reactive for αSMA and CD31. The diagnosis of PDS was established. The patient underwent PET/CT examination with a negative result. The cervical lymph nodes were not enlarged. A wide re-excision of the scar region was performed without evidence of residual tumor. The patient continues to be monitored, currently without signs of recurrence.

Conclusion: PDS represents a diagnostic challenge for pathologists. It mostly occurs in old men in the capillitium and in this location, which is typical for non-melanoma skin cancer, represents an important differential diagnosis. Its differentiation from the histogenetically and structurally related but clinically much more favorable AFX can be very difficult, but essential in terms of further prognosis and clinical management of the patient.

Keywords: pleomorphic dermal sarcoma, atypical fibroxanthoma, cutaneous sarcomas.

Accepted: February 27, 2025; Published: March 10, 2025  Show citation