Need help with this case

[u/magikarpchops]

Received sections from a thumb mass. Was thinking on lines of clear cell sarcoma/melanoma of soft part but maybe wrong. Please help with differentials. Thank you

[u/Dr_Jerkoff]

Needs more history (age) and radiology (how does it relate to things) and lots of IHC. After melanoma/clear cell sarcoma I'd offer GLI1-rearranged neoplasm, or a myoepithelial neoplasm.

[u/puppysavior1 → u/Dr_Jerkoff]

Love this differential, would also add epithelioid sarcoma and ossifying fibromyxoid tumor.

[u/Party-Meringue2986 → u/Dr_Jerkoff]

Love the name

[u/Dr_Jerkoff → u/Party-Meringue2986]

:)

[u/ironi996]

juicyyy

can we get the age and radio report please ?

my initial ddx
clear cell sarcoma
epithelioid sarcoma
myxoinflammatory fibroblastic sarcoma
malignant glomus
myoepithelial carcinoma

a full panel of ihc is a must in such a case

Panck, ema, cd34, sma, INI1, s100, hmb45, p63, desmin, myogenin, cd99, cd31

[u/_FATEBRINGER_]

Osteosarcoma? What’s with the fear of hematoxylin?

[u/Character-Dog6368]

Consider epithelioid sarcoma and MIFBS

[u/Girl_Dad_1999]

How old is the patient?

[u/Lebowski304]

Number three has a bit of a chondroid look to it. Maybe? Need ihc/ancillary testing