Sclerosing epithelioid fibrosarcoma metastasizing to the penile shaft

Abstract

We present the case of a 50-year-old man with a periurethral mass. He was previously known for sclerosing epithelioid fibrosarcoma (SEF) of the left foot, having an amputation for local recurrence with >2 cm negative margins. A solid periurethral mass was surgically excised seven months later, yielding the diagnosis of metastatic SEF. This is the first documented metastasis of SEF to the penis. These sarcomas have proven difficult to treat, with high recurrence rates despite a multimodal approach.

Fig. 1

(A) Low-power view of the lesion in the foot showing a well-circumscribed suprafascial neoplastic nodule; (B) the neoplastic cells grow in cords and as single cells and are separated by a heavily sclerotic stroma; (C) the cells are round, monotonous with mild degree of nuclear atypia; (D) the penile lesion showing identical morphology with extension to the inked peripheral surgical margin.