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Virtual Pediatric Hospital: Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease: Case 15 Thoracopaedia: An Imaging Encyclopedia of Pediatric Thoracic Disease

Case 15

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

Chief Complaint:
Twenty year old male with a chest wall mass

Clinical History:
The patient was a 20 year old male who had acute lymphocytic leukemia as a 3 year old child, who now presented with a new chest wall mass.

Clinical Physical Exam:
There was a palpable mass in the region of the sternum.

Clinical Labs:

Clinical Differential Diagnosis:
Soft tissue sarcoma

Imaging Findings:
An enhanced chest CT exam demonstrated a heterogeneous mass anterior to the lower sternum and peripheral pulmonary nodules.

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Imaging Differential Diagnosis:
Ewing sarcoma, osteomyelitis

Operative Findings:
A biopsy of the anterior chest wall mass was performed.

Pathological Findings:
Examination of the pathological specimen revealed a mid and deep dermal malignant spindle and polygonal, large cell tumor with histological and immunohistochemical features most consistent with epithelioid sarcoma.

Final Diagnosis:
Epithelioid Sarcoma, Chest Wall

Follow-up and Prognosis:
The patient had an uncomplicated post-biopsy course.

Similar Cases:
Case 18, Case 27, Case 46, Case 67, Case 68, Case 29


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