Primary Cutaneous Clear Cell Sarcoma, Clinical Outcome With Sentinel Lymph Nodes Status.

OBJECTIVES: Primary cutaneous clear cell sarcoma (PCS) is a rare malignancy and difficult to differentiate from melanoma. We investigated factors influencing survival and recurrence. METHODS: An institutional cancer registry and literature search were used for a retrospective study. Only clear cell sarcoma cases with a primary site of skin and subcutaneous tissue were included. Kaplan-Meier and Cox regression analyses were used to assess survival time and hazard ratios. RESULTS: Three eligible cases were identified at our institution. In addition, the PubMed and Google Scholar reviews identified 1,878 items, with 23 patients with PCS. The median age was 25 years with 62% female. The tumors ranged in size from 0.4 to 4.5 cm. Cytogenetics showed t(12;22)(q13;q12) in all cases and a unique variant of t(2;22)(q32.3;q12) in one case. Surgery was the most common treatment, followed by chemotherapy/radiation. PCS recurred in 46% of patients with a median relapse-free survival time of 15 months. Only two known PCS-related mortalities were recorded, at 38 and 60 months following initial diagnosis. Smaller tumor size and negative sentinel lymph node biopsy (SLNB) status were significantly associated with a better disease-free survival. CONCLUSIONS: Tumor size and SLNB status influence PCS survival and recurrence. More research is needed due to the rarity of this disease.

Herpes zoster following intra-articular corticosteroid injection.

Localized herpes zoster following intra-articular corticosteroid injection is remarkable. We describe an 80-year-old woman with severe osteoarthritis that received an intra-articular injection of 80 mg methylprednisolone in her knee, followed 1 day later by the appearance of linear unilateral vesicles and bullae on her leg in a dermatomal distribution adjacent to the injection site. The roofs of several blisters showed classic viral cytopathic effects for herpes including keratinocytes with multinucleation and margination of chromatin. Varicella zoster virus immunostaining revealed positive staining in the keratinocytes. One plausible explanation is herpes zoster virus reactivation secondary to localized immunosuppression from corticosteroid injection.

A t(12;17) in an extraorbital giant cell angiofibroma.

We report a case of a 43-year-old male who presented with a large soft-tissue neck mass 7 years ago. A diagnosis of giant cell angiofibroma (GCA) was made on the basis of light microscopy and immunohistochemical studies. Chromosome analysis showed a male karyotype with t(12;17)(q15;q23),del(18)(q21) in all 20 cells analyzed. This cytogenetic abnormality in GCA is different from the t(17;22)(q22;q13) found in related lesions, such as giant cell fibroblastoma and solitary fibrous tumor, none of which has a specific chromosomal abnormality. Our case is the second case of GCA with chromosomal aberrations. To the best of our knowledge, this is the first case of GCA with t(12;17) occurring as an extra-orbital mass.

Sebaceous hyperplasia of the vulva: case report and review of the literature.

Sebaceous hyperplasia is a cutaneous lesion consisting of soft, yellow, papular lesions usually occurring on the face in elderly patients. The occurrence of the lesion on the vulva is exceptionally rare. We were able to identify only three cases reported in the literature. We report a case of sebaceous hyperplasia of the vulva with an unusual presentation.