PMC9957587_01
Resected forearm nodule status post-CAV/IMV chemotherapy. Resected forearm nodule status post cyclophosphamide, doxorubicin, and vincristine (CAV) and ifosfamide and etoposide (IMV) chemotherapy demonstrating subcutaneous tumor bed with therapy-related changes including fibrosis, histiocytic infiltration, and hemosiderin deposition and lack of residual sarcoma (A, hematoxylin and eosin (H&E) X40). Metastatic lung nodule with focal viable tumor (upper left) and extensive necrosis (B, H&E X20). Viable sarcoma demonstrating sheets of small round blue cells clustered around pulmonary vessels (C, H&E X40). Tumor cells with hyperchromatic round to oval nuclei, inconspicuous nucleoli, and moderate amounts of clear to pale eosinophilic cytoplasm in a myxoid background, consistent with CIC-rearranged sarcoma (D, H&E X400).
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FIG1
The pathology on the resection showed no definite residual viable tumor (Figure 1). Twenty-six months after starting chemotherapy, a 1-cm lung nodule was noted and removed; pathological examination showed a malignant round cell neoplasm with 90% necrosis consistent with metastasis of the CIC-rearranged sarcoma (Figure 1).