Soft tissue sarcoma with metastasis to the stomach: a case report

Abstract

Soft tissue sarcomas are unusual malignancies comprising 1% of cancer diagnoses in the United States. Undifferentiated pleomorphic sarcoma accounts for approximately 5% of sarcomas occurring in adults. The most common site of metastasis is the lung, with other sites being bone, the brain, and the liver. Metastasis to the gastrointestinal tract has rarely been documented. We present an unusual case of high-grade pleomorphic sarcoma with metastasis to the stomach, complicated by upper gastrointestinal bleeding.

Figure 1

Large left shoulder mass.

Figure 2

Chest computed tomography scan showing mass of left posterior chest (A) and suspected left pulmonary metastasis (B).

Figure 3

High-grade pleomorphic sarcoma show large pleomorphic tumor cells in a fibrous stroma with numerous mitotic figures (A), tumor cells show a strong diffuse cytoplasmic immunoreactivity to vimentin (B). Other immunoreactions failed to discern any line of differentiation. The “vimentin only” immunophenotype leads to a diagnosis of undifferentiated pleomorphic sarcoma.

Figure 4

Resected left shoulder mass (A), cross section of resected shoulder mass showing central necrosis and smooth glistening dense fish flesh like tumor at the periphery (B).

Figure 5

Endoscopic view of the stomach shows a mass with surface ulceration and blood clots (A), the photomicrograph (B) reveals a malignant neoplasm, composed of densely cellular stroma with spindle cells containing pleomorphic nuclei.