Clear Cell Sarcoma of Tendon and Aponeuroses with Excessive Melanin Production – An Unusual Presentation

Clear cell sarcoma of tendons and aponeuroses also called as malignant melanoma of soft parts is a rare tumor of neural crest origin with 70% of them possessing balanced translocation t(12; 22). Approximately 50% of the tumor produces melanin which often shows focal pigmentation or needs special stains to demonstrate melanin. Production of excessive melanin by this tumor is very unusual and very few case reports are available in literature. We report a case of Clear cell sarcoma with excessive melanin production in a 50-year-old female patient involving the left popliteal fossa.

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Clear-Cell Sarcoma of Tendons and Aponeuroses Studied by Immunoscintigraphy

Nuklearmedizin ◽

10.1055/s-0038-1629821 ◽

1995 ◽

Vol 34 (04) ◽

pp. 170-172 ◽

Cited By ~ 1

Author(s):

Rosário Vieira ◽

A. Marques ◽

Odete Almeida ◽

Oliveira Costa ◽

Margarida Rodrigues

Keyword(s):

Monoclonal Antibody ◽

Malignant Melanoma ◽

Clear Cell ◽

Clinical Course ◽

Clear Cell Sarcoma ◽

Rare Tumor ◽

Cell Sarcoma

SummaryClear-cell sarcoma is a rare tumor that arises in association with tendons and aponeuroses. Although it shares with malignant melanoma several histologic and ultrastructural features, it has a clinical course different from that of conventional melanomas. A case of clear-cell sarcoma studied by immunoscintigraphy with 99mTc-labeled F(ab’)2 fragments of the monoclonal antibody 225.28 S is reported.

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Malignant Melanoma of Soft Parts (Clear Cell Sarcoma): A Case Report

The Journal of Dermatology ◽

10.1111/j.1346-8138.2003.tb00431.x ◽

2003 ◽

Vol 30 (7) ◽

pp. 550-555 ◽

Cited By ~ 3

Author(s):

Takuya Seike ◽

Kazuya Matsumoto ◽

Hideki Nakanishi ◽

Ichiro Hashimoto ◽

Yoshiaki Kubo ◽

...

Keyword(s):

Case Report ◽

Malignant Melanoma ◽

Clear Cell ◽

Clear Cell Sarcoma ◽

Cell Sarcoma

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Is clear cell sarcoma a malignant form of psammomatous melanotic schwannoma?

Neurosurgical FOCUS ◽

10.3171/foc.2006.21.6.3 ◽

2006 ◽

Vol 21 (6) ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Ahmet Şengöz ◽

Erol Taşdemiroğlu ◽

Halit Togay

Keyword(s):

Malignant Melanoma ◽

Nerve Root ◽

Clear Cell ◽

Clear Cell Sarcoma ◽

Histopathological Diagnosis ◽

Total Resection ◽

Cell Sarcoma ◽

Melanotic Schwannoma ◽

Psammomatous Melanotic Schwannoma

✓The authors present a case of clear cell sarcoma (CCS) in which the tumor originated in the S-1 nerve root and had been previously diagnosed as psammomatous melanotic schwannoma (PMS). This is the third case of a spinal nerve root origin for CCS reported in the English-language literature. The similar histogenesis of CCS and malignant melanoma supports the hypothesis that biological agents or immunotherapy are potentially important areas of investigation. The patient underwent S1–3 laminectomy and gross-total resection of the mass lesion. The border of the resection was extended 1 cm distal to the tumor margin. The postoperative period was uneventful. The new histopathological diagnosis was CCS (malignant melanoma of soft tissue). Despite total resection, the patient returned with disseminated disease at the 18-month follow-up visit. His follow-up magnetic resonance image of the lumbar spine revealed sacral L5–S3 involvement of the vertebral bodies along with disseminated cauda equina seeding. A CCS originating from peripheral nerves is quite rare. The histopathological and immunohistochemical appearance of CCSs resembles those of PMSs. Surgery should be the first choice of treatment.

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Epithelial-Type and Neural-Type Cadherin Expression in Malignant Noncarcinomatous Neoplasms With Epithelioid Features That Involve the Soft Tissues

Archives of Pathology & Laboratory Medicine ◽

10.5858/2002-126-0425-etantc ◽

2002 ◽

Vol 126 (4) ◽

pp. 425-431 ◽

Cited By ~ 4

Author(s):

William B. Laskin ◽

Markku Miettinen

Keyword(s):

Malignant Melanoma ◽

Synovial Sarcoma ◽

Soft Tissues ◽

Clear Cell ◽

Epithelioid Sarcoma ◽

Clear Cell Sarcoma ◽

Extraskeletal Myxoid Chondrosarcoma ◽

Cell Sarcoma ◽

Myxoid Chondrosarcoma ◽

Poorly Differentiated

Abstract Context.—Transmembrane adhesion molecules, epithelial-type cadherin (ECAD) and neural-type cadherin (NCAD), help in regulating transformations between epithelial and mesenchymal cells in the developing embryo and in maintaining the epithelioid phenotype. Consequently, the presence of epithelioid cells in certain malignant noncarcinomatous neoplasms raises speculation that the expression of ECAD and NCAD in these neoplasms may have diagnostic significance. Objective.—To investigate the utility of ECAD and NCAD immunoexpression in distinguishing malignant (noncarcinomatous) neoplasms with epithelioid features that involve the soft tissues. Design.—Membranous immunoreactivity of anti-ECAD and anti-NCAD was evaluated on archived cases selected from the files of the Armed Forces Institute of Pathology. Results.—Epithelial-type cadherin was found in biphasic synovial sarcoma (35 of 35 cases), malignant melanoma (13/21), monophasic fibrous synovial sarcoma (13/26), clear cell sarcoma (4/9), poorly differentiated synovial sarcoma (3/13), diffuse mesothelioma (4/20), malignant epithelioid peripheral nerve sheath tumor (1/6), and epithelioid sarcoma (5/62). Neural-type cadherin was observed in chordoma (11/11), biphasic synovial sarcoma (30/35), diffuse mesothelioma (14/20), malignant melanoma (14/25), epithelioid sarcoma (24/63), epithelioid angiosarcoma (1/4), poorly differentiated synovial sarcoma (2/13), clear cell sarcoma (1/10), and monophasic fibrous synovial sarcoma (1/26). Eighteen cases of primary cutaneous squamous cell carcinomas all tested positive for ECAD, whereas NCAD was focally observed in 5 cases. No expression of either molecule was observed in cases of epithelioid hemangioendothelioma (n = 9), alveolar soft part sarcoma (n = 8), and extraskeletal myxoid chondrosarcoma (n = 7). Conclusions.—Epithelial-type and neural-type cadherins are found in a variety of noncarcinomatous neoplasms with epithelioid features that involve the soft tissues and can be utilized, in association with other immunomarkers, in distinguishing chordoma (100% NCAD) from extraskeletal myxoid chondrosarcoma and conventional chondrosarcoma of bone (0% NCAD), squamous cell carcinoma (100% ECAD) from epithelioid sarcoma (8% ECAD), and biphasic synovial sarcoma (100% ECAD) from diffuse mesothelioma (20% ECAD).

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