PMID- 36589177
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230103
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 11
DP  - 2022 Nov
TI  - Clear-Cell Sarcoma With an Unusual Presentation Mimicking Metastatic Melanoma.
PG  - e32010
LID - 10.7759/cureus.32010 [doi]
LID - e32010
AB  - Clear-cell sarcoma (CCS) was first described in 1968. It partly overlaps 
      morphologically, immunohistochemically, and ultrastructurally with malignant 
      melanoma (MM), hence its name "soft tissue melanoma." Nevertheless, there are 
      sufficient cytogenetic differences between cutaneous melanoma and clear-cell 
      sarcoma to consider clear-cell sarcoma as a separate entity. Clear-cell sarcoma 
      of soft tissue is different from clear-cell sarcoma of the kidney. It is 
      classified as a tumor of uncertain differentiation in the WHO 2020 classification 
      of soft tissue tumors. It is an aggressive, rare malignant tumor that is involved 
      in the deep soft tissues of the extremities and trunk. We report a case of 
      primary clear-cell sarcoma of unusual presentation in a 31-year-old young man, 
      mimicking metastatic melanoma. A 31-year-old man presented with a heel mass of 
      2.5 cm. Histologically, it was a dermal and hypodermal nodular proliferation of 
      spindle cells of 23 mm with a grenz zone under the epidermis. There was no 
      necrosis area or lymphovascular invasion. Surgical margins were free. There were 
      no clinically suspicious lymph nodes. The tumor cells were stained for S100 
      protein, MELAN A, and HMB45, which led to an initial diagnosis of metastatic 
      malignant melanoma. However, analysis by fluorescence in situ hybridization 
      (FISH) found a rearrangement of the Ewing sarcoma region 1 (EWSR1) gene, which 
      led to a diagnosis of primary clear cell sarcoma in the skin. This case 
      highlights the importance of considering the diagnosis of a clear-cell sarcoma in 
      front of any dermal lesions with morphological and immunohistochemical 
      melanocytic features that do not have an in situ component and of atypical 
      presentation, especially in young patients, hence the interest in performing 
      fluorescence in situ hybridization for EWSR1, which remains the key to the 
      diagnosis of cutaneous clear-cell sarcoma.
CI  - Copyright (c) 2022, Tahiri Elousrouti et al.
FAU - Tahiri Elousrouti, Layla
AU  - Tahiri Elousrouti L
AD  - Department of Pathology, Hassan II University Hospital, Biomedical and 
      Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed 
      Ben Abdellah University, Fes, MAR.
FAU - Hammas, Nawal
AU  - Hammas N
AD  - Department of Pathology, Hassan II University Hospital, Biomedical and 
      Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed 
      Ben Abdellah University, Fes, MAR.
FAU - Elmernissi, Fatima Zahra
AU  - Elmernissi FZ
AD  - Department of Dermatology and Venerology, Hassan II University Hospital, Fes, 
      MAR.
FAU - Elfatemi, Hinde
AU  - Elfatemi H
AD  - Department of Pathology, Hassan II University Hospital, Biomedical and 
      Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed 
      Ben Abdellah University, Fes, MAR.
FAU - Chbani, Laila
AU  - Chbani L
AD  - Department of Pathology, Hassan II University Hospital, Biomedical and 
      Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed 
      Ben Abdellah University, Fes, MAR.
LA  - eng
PT  - Case Reports
DEP - 20221129
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9798674
OTO - NOTNLM
OT  - case report
OT  - clear cell sarcoma
OT  - cutaneous
OT  - fluorescence in situ hybridization
OT  - immunohistochemistry(ihc)
OT  - melanoma
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/01/03 06:00
MHDA- 2023/01/03 06:01
PMCR- 2022/11/29
CRDT- 2023/01/02 03:51
PHST- 2022/11/24 00:00 [accepted]
PHST- 2023/01/02 03:51 [entrez]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/01/03 06:01 [medline]
PHST- 2022/11/29 00:00 [pmc-release]
AID - 10.7759/cureus.32010 [doi]
PST - epublish
SO  - Cureus. 2022 Nov 29;14(11):e32010. doi: 10.7759/cureus.32010. eCollection 2022 
      Nov.