title: [Lung metastases of epithelioid sarcoma revealed by bilateral spontaneous pneumothorax: a pathological diagnosis].
abstract: Spontaneous pneumothorax may be one of the presenting manifestation of metastatic epithelioid sarcoma even if imaging does not show evident metastatic nodules. We report the case of a 24-year-old man presenting a bilateral spontaneous pneumothorax in association with an epithelioid sarcoma developed in the right foot. CT-scan revealed bilateral microcystic lesions with no evidence of metastatic disease. A left thoracoscopy and a pleurodesis were performed. Persistent air leakage led to a thoracotomy during which lung biopsies were carried out. Histopathological examination of the pulmonary biopsies revealed rare millimetric nodules, composed of very atypical epithelioid cells, growing along alveolar walls reminiscent of a bronchiolo-alveolar carcinoma. However, these cells and primary neoplastic cells of the foot tumour were morphologically and immunohistochemically similar and the atypical pulmonary cells were TTF1 negative. All these constatations allowed a diagnosis of pulmonary metastases of the epithelioid sarcoma. This very unusual case underlines that sarcomatous metastases may be a clinical and pathological pitfall.
authors.affiliation: Service d'anatomie et cytologie pathologiques, hôpital de la Croix-Rousse, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France. raphaelle.barnoud@chu-lyon
authors.forename: Raphaëlle
authors.initials: R
authors.lastname: Barnoud
authors.forename: Sophie
authors.initials: S
authors.lastname: Collardeau-Frachon
authors.forename: Eric
authors.initials: E
authors.lastname: de la Roche
authors.forename: Alexandre
authors.initials: A
authors.lastname: Vasiljevic
authors.forename: Vivien
authors.initials: V
authors.lastname: Thomson
authors.forename: Dominique
authors.initials: D
authors.lastname: Ranchère
authors.forename: Gilles
authors.initials: G
authors.lastname: Devouassoux
authors.forename: Mojgan
authors.initials: M
authors.lastname: Devouassoux-Shisheboran
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D004317:Doxorubicin / Q000008:administration & dosage; D004322:Drainage; D017809:Fatal Outcome; D005534:Foot Diseases / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D008175:Lung Neoplasms / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D009363:Neoplasm Proteins / Q000032:analysis; D018700:Pleurodesis; D011030:Pneumothorax / Q000209:etiology*; D012509:Sarcoma / Q000737:chemistry / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D013906:Thoracoscopy; D013908:Thoracotomy; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D004317:Doxorubicin; D007069:Ifosfamide