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2010 — September Case of the Month

Posted October 06, 2010

CLINICAL SUMMARY: LEFT BUTTOCK  

CAP Foundation September 2010 Online Case of the Month

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A 19-year-old Caucasian man presented with a rapidly growing, painful, firm mass of the left buttock. Imaging revealed a heterogeneously enhancing 8.0 cm mass in the sacrococcygeal area without bony involvement. An excisional biopsy revealed an ill-defined heterogeneous mass with a grey-tan, somewhat friable cut surface, and gross areas of hemorrhage and necrosis. Immunohistochemistry showed strong membranous staining for CD99, with negative reactivity for multiple cytokeratins, CD45, desmin, smooth muscle actin, S100 protein, synaptophysin, chromogranin, and MyoD-1. Fluorescence in-situ hybridization performed on touch preparations of the tumor showed the presence of a t(11;22) translocation in all examined tumor cells.

The master list with the correct answer

  • Alveolar rhabdomyosarcoma
  • Desmoplastic small round cell tumor
  • Ewing sarcoma/Primitive neuroectodermal tumor
  • Lymphoblastic lymphoma
  • Metastatic small cell carcinoma
  • Neuroblastoma

Access Case Critique to view:

  • Appropriate diagnosis
  • Critique
  • References


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