Unusual bleeding of a giant cell fibroblastoma: a soft tissue sarcoma of the skin mimicking metastatic melanoma


COD: 2370_30_04_2015_ep Categorie: ,

Maurizio Castriconi, Massimo Antropoli, Maurizio Grillo, Mauro Andreano, Mariangela Santoro, Elisabetta Villamania

Ann. Ital. Chir.Published online (EP) 30 April 2015

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A 56 year-old man presented to the emergency department after a spontaneous bleeding of a giant mass located on theright axilla. Clinical diagnosis was recurrent hemorrhagic nodular melanoma. Ten months previously a malignantmelanoma 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 wasbleeding and the patient required a transfusion. Subjective symptoms included pain in palpation and spontaneous hem-orrhage, 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 tumorfree margin. The resultant defect was reconstructed by pectoral rotation fascio-cutaneous flap. The histological diagnosisdemonstrated an undifferentiated high-grade pleomorphic sarcoma with microscopic tumor free margins.