Unusual bleeding of a giant cell fibroblastoma: a soft tissue sarcoma of the skin mimicking metastatic melanoma.
Maurizio Castriconi 1, Massimo Antropoli 1, Maurizio Grillo 1, Mauro Andreano 1, Mariangela Santoro 2, Elisabetta Villamania 3
Affiliations
Article Info
1 UOC Chirurgia d’Urgenza Dipartimento di Emergenza Autonomo, AO “Cardarelli “Napoli, Italy
2 UO Chirurgia Plastica Ricostruttiva ed Estetica, Seconda Università degli Studi, Napoli, Italy
3 UO Chirurgia Generale Università “Federico II”, Napoli, Italy
Abstract
A 56 year-old man presented to the emergency department after a spontaneous bleeding of a giant mass located on the right axilla. Clinical diagnosis was recurrent hemorrhagic nodular melanoma. Ten months previously a malignant melanoma had been removed from the dorsum by radical excision and surgical margins had been disease-free (MM: Breslow IV, Clark IV, lung and lynphnode metastases). The patient required immediate emergency surgical intervention to prevent death by hemorrhagic shock. The tumor was bleeding and the patient required a transfusion. Subjective symptoms included pain in palpation and spontaneous hemorrhage, poor general appearance, pale skin, BP 80/40 mmHg, HR 100/min with overall symptoms of hypovolemic shock. At the time of surgery, radical tumor excision was performed with an approximately 3 cm circumferential gross tumor free margin. The resultant defect was reconstructed by pectoral rotation fascio-cutaneous flap. The histological diagnosis demonstrated an undifferentiated high-grade pleomorphic sarcoma with microscopic tumor free margins.
Keywords
- Melanoma
- Skin bleeding
- Soft tissue sarcoma
