Mesenchymal chondrosarcomas (MC) are a rare and aggressive neoplasm characterized by primitive mesenchymal cells mixed with well differentiated islands of cartilage. MCs account for 2%-9% of all chondrosarcomas and typically metastasize to bones of the spine, ribs, or jaw with a ten-year survival rate of 27%. MC most commonly occurs in the second and third decades of life. Myxoid round cell liposarcomas (MRCL) are a form of liposarcoma neoplasm which occur in up to 30% of liposarcoma cases. Most MRCL cases occur between the second and third decade of life with a higher percentage of round cells associating with poorer prognosis. Surgical resection of MRCL is the most common treatment, with 14% of cases reoccurring following resection. A higher rate of recurrence is associated with a larger round cell component. 67% of recurrence cases of MRCL are associated with metastasis within 17 months. We report an unusual case of Mixed Mesenchymal Chondrosarcoma/Myxoid Round Cell Liposarcoma with later Recurrence as a Metastatic High-Grade Undifferentiated Round Cell Sarcoma and we review the literature.

Giant cell tumors of the bone (GCTB), while often benign, are regarded as locally aggressive and highly unpredictable with the capability to recur, metastasize, and even undergo sarcomatous transformation into a malignant variant. There have been inconsistent views regarding histomorphology, radiography and local occurrence of GCTB, and metastatic malignant GCTB. Herein, we describe the histological features of a case of GCTB with such atypical foci in which the initial diagnosis of malignancy was amended to a benign metastatic giant cell tumor. Whether the creation of a “borderline” or “atypical” GCTB category is necessary is yet to be determined.

Gastrointestinal stromal tumors (GISTs) are rare, making up less than 1% of all gastrointestinal tumors. Each year, approximately 4,000 to 6,000 adults in the United States will be diagnosed with a GIST. However, they are common mesenchymal tumors accounting for 80% of gastrointestinal mesenchymal tumors, as well as comprising 3-5% of all sarcomas and 1% of all gastrointestinal neoplasms. GISTs can occur along any location in the GI tract, but most GISTs are found in the stomach (60%), as well as the jejunum and ileum of the small intestine (20-30%). This case describes a 49-year-old male who presents with a malignant recurrent GIST two years after resection of a primary GIST. GISTs represent a problematic subset of gastrointestinal neoplasms due to the variability of immunohistochemistry and cytogenetics of the tumors across patients. GISTs should always be included in the differential diagnosis of presentation of a gastrointestinal mass. Early detection combined with complete resection of the mass, administration of tyrosine kinase inhibitors, as well as observation for possible recurrence is considered the current standard of care in patients with GIST.

Nocardiosis is a potentially lethal complication of organ transplantation. Each year, approximately 500 to 1000 cases of nocardiosis are diagnosed in the United States. Nocardiosis commonly occurs in the lung, brain, and heart of transplant recipients. This case describes a 63-year-old male who presents with a solitary brain and multiple pulmonary lesions. Nocardiosis represents a problematic diagnosis due to non-specific symptoms and imitation of more common differentials. Nocardiosis should always be included in the differential diagnosis of any patient who presents with brain, soft tissue, or cutaneous lesions and a concurrent or recent pulmonary lesion. Early detection combined with empiric antibiotic therapy is considered the current standard of care in patients with nocardiosis. We present a case of nocardiosis of the lung with hematogenous spread to the brain in post-transplant patient who responded well to treatment with complete recovery.

Myxoinflammatory fibroblastic soft tissue sarcomas are rare soft tissue sarcomas predominantly found in the upper extremities of middle-aged adults. Their rarity and diverse histological and anatomical presentations predispose to misdiagnosis oftentimes for more benign lesions such as ganglion cyst, giant cell tumor of the tendon sheath or tenosynovitis. This results in improper management in addition to delayed diagnosis placing patients at increased risk of worst-case scenarios including amputation, metastases or death. We are presenting the case of a 5-year-old female with myxoinflammatory fibroblastic soft tissue sarcoma of her hand initially misdiagnosed as a ganglion cyst, that recurred on two occasions after undergoing local excision. The reporting of this case aims to increase knowledge and awareness regarding the morphologic and immunohistochemical features of rare and often misdiagnosed myxoinflammatory fibroblastic soft tissue sarcomas. It is our hope that heightened awareness of this tumor will lead to inclusions as a differential diagnosis in soft tissue lesions of the extremities and thus avoid misdiagnosis and treatment.

Proximal epithelioid sarcoma is a rare malignancy that develops from the proximal part of the body and occurs more commonly in young people. Because of its aggressive nature, high recurrence potential, and high ability to metastasize, it needs careful clinical long-term monitoring. This report intends to provide more insight to proximal epithelioid sarcoma due to its rarity. We report a case of a 31-year-old immunochemistry, prognosis, and treatment of epithelioid sarcoma. male, presented with proximal-type epithelioid sarcoma in his right ischio-rectal fossa and inguinal lymph nodes metastasis, confirmed by cytology sampling examination utilizing ultrasound fine-needle aspiration. We review the cytohistological presentation, molecular basis,

Pleomorphic liposarcoma (PLS) is a high-grade sarcoma due to its high rate of recurrence and metastasis [1]. It accounts for only 5% to 15% of all liposarcomas [2]. PLS is most commonly located in the deep soft tissues of the extremities and retroperitoneum [1,3,4] and presents as a painless mass in middle aged and elderly adults [5]. One of the most characteristic features in diagnosis of PLS is the presence of pleomorphic lipoblasts [6]. Typically, sarcomatous tumors metastasize to the lungs [1], and rarely to the bone. This case report describes a 44-year-old male who presented with lung masses as well as masses infiltrating multiple rib bones. The histological and immunohistochemistry profile of these lesions was consistent with metastatic pleomorphic liposarcoma, originating in the thigh, that had been resected 3 years prior to current presentation. The reporting of this case aims to increase awareness of pleomorphic liposarcoma’s ability to metastasize, albeit rare, to the bone while also highlighting the usefulness of histology and immunohistochemistry to identify metastatic lesions of pleomorphic liposarcoma.

Cancer of the breast in the most common cancer among women. Rhabdomyosarcoma (RMS) of the breast is a rare sarcoma that is often diagnosed late. Only 5% of breast tumors are of nonepithelial origin, and only 0.2% of RMS originate in the breast. Optimal treatment of breast rhabdomyosarcoma is not standardized yet. RMS can present a serious diagnostic challenge due to its resemblance to benign tumors of the breast in imaging studies leading to late diagnosis and unfavorable prognosis. Little is known about standard treatment of breast rhabdomyosarcoma.

The 5-year survival rate for primary breast rhabdomyosarcoma is about 43%. We present a case of Primary Bilateral Rhabdomyosarcoma of the Breast in a young female with unusual clinical presentation with a review of the literature.

Angiosarcomas, which are endothelial in origin, make up less than 1% of all soft tissue sarcomas. For every million people in the United States, one will be diagnosed with an angiosarcoma. Most angiosarcomas are found in the breast, deep soft tissue of the head and neck, and skin, though they may rarely arise within other soft tissue sites. Epithelioid angiosarcomas represent a diagnostically challenging subset of angiosarcomas due to their non-specific imaging features, non-specific clinical presentation and rarity of the neoplasm. Epithelioid angiosarcomas should always be included in the differential diagnosis in patients with vascular neoplasms. Early detection combined with complete resection of the mass, as well as adjuvant therapy if possible, yields the highest favorable prognosis for patients with EAs.

Primary splenic neoplasms are rare and among these neoplasms are littoral cell angiomas (LCA). LCAs are benign vascular tumors arising from the littoral cells lining the splenic red pulp sinuses. LCAs are most often identified incidentally, although patients may present with hypersplenism such as anemia, thrombocytopenia, and splenomegaly. The incidence is found to be equal in both males and females and most reported cases are in middle aged adults. Most cases of LCA described in the literature have been composed of multiple lesions of varying size in the spleen. The pathogenesis of LCA is unknown; however the neoplasm is associated with immunological disorders and malignancies. We report a case of a patient diagnosed with a LCA of the spleen in association with metastatic abdominal leiomyosarcoma, along with a literature review.