A Case of Epitheloid Sarcoma on Metal Cutoff Worker / 대한산업의학회지

BACKGROUND: Soft tissue sarcoma is a rare condition with many causative factors. However a soft tissue sarcoma from a metallic foreign body and injury is rare. We report a case of a soft tissue sarcoma caused by a metallic foreign body and injury. CASE: The patient had been worked as a metal cutter for 17 years. While working, his palms were constantly pricked by small metallic splinters, which were generally removed after work. On march 2004, he had palpitated mass on his right palm. On November 2006, a right hand x-ray showed a mass and metallic foreign body at the 1st volar space which was confirmed to be an epitheloid sarcoma. All metallic products of his workplace contained chromium and Nickel. which are known to cause soft tissue sarcomas. A review of the literature revealed foreign-body and injury induced oxidative and nitrative stress to be associated with a developing sarcoma. In addition, Cr and Ni are associated with the development of sarcoma. Therefore it was concluded this case of epitheloid sarcoma was associated with his employment. CONCLUSION: A soft-tissue sarcoma associated with a metal foreign-body and injury is rare and their relationship is difficult understand. If a case of sarcoma is encountered on a metal associated worker, their job association should be considered.

Epitheloid Sarcoma in the Hand: A Case Report

Epitheloid sarcoma is rare malignant tumor of the skin, connective tissue, subcutaneous tissue and tendon sheath, which was first described by Enzinger in 1970. It is usually located in the extremities. We treated a 30-years-old man who developed an epitheloid sarcoma in the radial side of the left palm. The tumor was 2x1.6x1 cm sized, arose from the thenar muscle, and histologically the mass was composed of epitheloid cells. It was treated by wide local excision. However, after 2 months of initial operation, second operation and radiotheraphy was performed because of local recurrence. Because of its harmless appearance and similarity to an inflammatory response, it is often mistaken for a benign lesion.Even though it is a rare tumor, clinicians and pathologists should be aware of this malignant nature. Metastasis can be local or may involve draining lymph node and other distant organs, mostly the lung. Diagnosis is made on pathologic evaluation. Aggressive surgical approach is required in order to prevent recurrence, and radiotherapy and chemotherapy should be considered in all cases.