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Cutaneous soft tissue tumors: Diagnostically disorienting epithelioid tumors that are not epithelial, and other perplexing mesenchymal lesions

Modern Pathology Nov 14, 2019

Carter CS, et al. - Cutaneous soft tissue tumors with epithelioid peculiarities show a diagnostic challenge provuded that many entities in this category are rare, and they exhibit morphologic overlap with notably more prevalent cutaneous epithelial and melanocytic neoplasms. In some of these entities, the challenge is constituted by overlapping expression of epithelial or melanocytic markers. A broad spectrum of primary cutaneous epithelioid soft tissue tumors exists, including benign and malignant counterparts of tumors with different distinction like melanocytic, peripheral nerve sheath, angiomatous, fibrohistiocytic, and myoid or myoepithelial, additionally to translocation-related tumors deficient of a derivative tissue type. Provided this spectrum, for epithelioid dermal and subcutaneous neoplasms, a primary targeted immunohistochemical panel is suggested, overlaying a broad spectrum of distinction. In diagnostically challenging cases, select molecular studies could be used to make crucial differentiation between entities sharing morphologic and immunohistochemical features. Because of sometimes marked distinctions in prognosis and treatment, knowledge and familiarity with epithelioid soft tissue tumors is chief for any surgical pathologist who assesses skin and subcutaneous biopsies and excision specimens. Thus, brief descriptions, principal diagnostic characteristics, and significant modern ancillary studies for the diagnosis of non-epithelial, non-melanocytic cutaneous tumors that could show a conspicuous degree of epithelioid morphology were presented.
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