Metastatic Epithelioid Sarcoma ES with Pneumothorax, Hemoptysis and Thoracic Radiographic Bilateral Cavity Lesions in Young Male Patient – Case Report

Abstract

Epithelioid sarcoma is a rare soft tissue sarcoma in young adults (20-39 year olds) involving the upper extremities 60% of the time. The incidence of upper extremity epithelioid sarcoma was 0.1 cases per million per year [1]. This tumor is more common in males (1.8:1) and affects the young adult population [2]. It is a slow growing tumor with a high rate of recurrence and metastasis. In a long term study, 45% of patients with epithelioid sarcoma developed metastatic disease, with the lung (51%), lymph nodes (34%), scalp (22%) being the most common sites [3]. Close, long-term follow up is necessary because recurrence and metastases may occur long after definitive treatment. This case report documents young male patient with chest pain and right sided pneumothorax, for which he underwent decortication. After 6 months he presented with recurrent hemoptysis and bilateral cavity lesions. Bronchoscopy was done and showed active bleeding coming from right lower lobe. Surgical resection done to right middle and lower lobe. The histopathology tissue report came as epithelioid sarcoma.