Abstract
Clear cell sarcoma is a high-grade sarcoma with morphological features resembling those of malignant melanoma. An osteoclast-rich tumor of the gastrointestinal tract with features resembling those of clear cell sarcomas of soft parts is very rare. Herein, we report an unusual stomach tumor with microscopic and immunohistochemical characteristics of an osteoclast-rich tumor of the gastrointestinal tract with features resembling those of clear cell sarcomas of soft parts. The tumor cells were predominantly oval, admixed with some round and spindle elements arranged in nests and fascicles, and admixed with scattered osteoclast-like multinucleated giant cells. Neoplastic cells were positive for S-100 protein, and osteoclast-like multinucleated giant cells were immunoreactive to CD68. The unusual morphology of the tumor caused significant diagnostic difficulties. The differential diagnosis included gastrointestinal stromal tumor, primary or metastatic melanoma, and epithelioid malignant peripheral nerve sheath tumor. To the best of our knowledge, this is possibly the second description of an osteoclast-rich tumor of the gastrointestinal tract with features resembling those of clear cell sarcomas of soft parts.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Chalkiadakis G, Wihlm JM, Morand G, Weill-Bousson M, Witz JP (1985) Primary malignant melanoma of the esophagus. Ann Thorac Surg 39:473–475
Chan JKC (1999) Mesenchymal tumors of the gastrointestinal tract: a paradise for acronyms (STUMP, GIST, GANT, and now GIPACT). Implications of c-kit in genesis, and yet another of many emerging roles of the interstitial cell of Cajal in the pathogenesis of gastrointestinal disease. Adv Anat Pathol 6:19–40
Christova S, Meinhard K, Mihailov I, Alexiev B (1996) Three cases of primary malignant melanoma of the alimentary tact. Gen Diagn Pathol 142:63–67
Deenik W, Mooi WJ, Rutgers EJ, Peterse JL, Hart AA, Kroon BB (1999) Clear cell sarcoma of soft parts. A clinicopathological study of 30 cases. Cancer 86:969–975
Donner LR, Trompler RA, Dobin S (1998) Clear cell sarcoma of the ileum: the crucial role of cytogenetics for the diagnosis. Am J Surg Pathol 22:121–124
Ekfars TO, Kujari H, Isomäki M (1993) Clear cell sarcoma of tendons and aponeurosis in the duodenum: the first visceral case. Histopathology 22:255–259
Insabato L, Vizio DD, Ciancia G, Pettinato G, Tornillo L, Terracciano L (2004) Malignant gastrointestinal leiomyosarcoma and gastrointestinal stromal tumor with prominent osteoclast-like giant cells. Arch Pathol Lab Med 128:440–443
Kadivar TF, Vanek VW, Krishnan EU (1992) Primary malignant melanoma of the small bowel: a case study. Am Surg 58:418–421
Leung KM, Wong S, Chow TC, Lee KC (2002) A malignant gastrointestinal tumor with osteoclast-like giant cells. Arch Pathol Lab Med 126:972–974
Macak J (1998) Melanoma of the stomach: reality & fiction? Pathologica 90:388–390
Medeiros F, Corless CL, Duensing A, Hornick JL, Oliveira AM, Heinrich MC, Fletcher JA, Fletcher CD (2004) KIT-negative gastrointestinal stromal tumors: proof of concept and therapeutic implications. Am J Surg Pathol 28:889–894
Miettinen M, Sarlomo-Rikala M, Lasota J (1998) Gastrointestinal stromal tumours. Ann Chir Gynaecol 87:278–281
Pauwels P, Debiec-Rychter M, Sciot R, Vlasveld T, den Butter B, Hagemeijer A, Hogendoorn PC (2002) Clear cell sarcoma of the stomach. Histopathology 41:526–530
Quinn JM, Elliott J, Gillespie MT, Martin TJ (1998) A combination of osteoclast differentiation factor and macrophage-colony stimulating factor is sufficient for both human and mouse osteoclast formation in vitro. Endocrinology 139:4424–4427
Rao GM, Satyanarayana Y, Janaki M, Hayath MS (1999) Primary melanocarcinoma of stomach. Indian J Gastroenterol 18:176
Sachs DL, Lowe L, Chang AE, Carson E, Johnson TM (1999) Do primary small intestinal melanomas exist? Report of a case. J Am Acad Dermatol 41:1042–1044
Stranks G, Mathai J, Rowe-Jones D (1991) Primary malignant melanoma of the esophagus: case report and review of surgical pathology. Gut 32:828–829
Terada T, Endo K, Maeta H, Horie S, Ohta T (2000) Epithelioid leiomyosarcoma with osteoclast-like giant cells in the rectum. Arch Pathol Lab Med 124:438–440
van Roggen JFG, van Velthuysen MLF, Hogendoorn PCW (2001) The histopathological differential diagnosis of gastrointestinal stromal tumours. J Clin Pathol 54:96–103
Zambrano E, Reyes-Mugica M, Franchi A, Rosai J (2003) An osteoclast-rich tumor of gastrointestinal tract with features resembling clear cell sarcoma of soft parts: reports of 6 cases of a GIST simulator. Int J Surg Pathol 11:75–81
Zheng MH, Fan Y, Smith A, Wysocki S, Papadimitriou JM, Wood DJ (1998) Gene expression of monocyte chemoattractant protein-1 in giant cell tumors of bone osteoclastoma: possible involvement in CD68+ macrophage-like cell migration. J Cell Biochem 70:121–129
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Huang, W., Zhang, X., Li, D. et al. Osteoclast-rich tumor of the gastrointestinal tract with features resembling those of clear cell sarcoma of soft parts. Virchows Arch 448, 200–203 (2006). https://doi.org/10.1007/s00428-005-0051-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00428-005-0051-y