PMC10288419_01
(a) Clinical feature: exophytic, ulcerated, hemorrhagic nodular tumor of 7 cm, over the right thigh (arrow). (b) Macroscopically, dermo-hypodermic tumor, multinodular, whitish with hemorrhagic areas (circle).
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A 92-year-old female with no significant medical history, coming with a 7 cm exophytic, ulcerated, hemorrhagic nodular tumor rapidly growing for 8 months over the right thigh (Figure 1a and b).
Tumor section, sheets of clear cells with numerous branching capillaries between tumor cells (hematoxylin and eosin stain x100).
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Histological examination after 10% buffered formalin fixation, impregnation, and block paraffin embedding, showed a dermal, and subcutaneous neoplasm with irregular nests and nodules, numerous branching capillaries were noted between tumor cells (Figure 2).
Higher magnification shows there are cellular atypia and atypical mitotic figures (hematoxylin and eosin stain x400).
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Cells had abundant clear cytoplasm and enlarged polymorphic and vesicular nuclei with prominent nucleoli (Figure 3).
Immunohistochemical staining (a) cytoplasmic positive staining of Melan A (x400) (b) membranous and cytoplasmic positive staining of smooth muscle actin (SMA) (x400), (c) membranous positive staining of CD 10 (x400). (d) Positive staining of CD34 highlighting numerous thin-walled capillaries between tumor cells (x100).
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On immunohistochemistry, tumor cells co-expressed smooth muscle, and melanic markers, they are positive for Melan-A (Figure 4a), and smooth muscle actin (SMA; Figure 4b), they also expressed vimentin, CD10 (Figure 4c), and CD68. It should be noted that the immunostaining by CD34 highlighted the numerous branching capillaries between tumor cells (Figure 4d).