5/2/2006 Case 2: Sarcoma

Clinical History:

This was a case of an extradural cervicothoracic spinal cord tumor which, at first operation, was apparently attached to a nerve root. Dr Shao demonstrated images from two different operations from what appeared to be a malignant tumor with a prominent spindle cell component.

Diagnostic Notes:

There were extensive spindle cell areas, there was considerable pleiomorphism, and there was a brisk proliferative rate. The overall impression was of a sarcoma, and there was considerable discussion as to the type of soft tissue sarcoma and the criteria for making specific diagnoses. The tumor had some CD99 immunopositivity but on testing did not have a proven translocation for a diagnosis of synovial sarcoma or Ewing's Sarcoma; Fli-l was not tested. There was one diagnosis offered by an outside consultant of "carcinoma" which the members present found difficult to entertain. Dr Shao did not have a preferred specific diagnosis and was seeking advice from the
group.

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