Myxoid Epithelioid Sarcoma: Clinicopathologic Analysis of 2 Cases

In the nearly 4 decades since its original delineation as a distinct clinicopathologic entity, several morphologic variations of epithelioid sarcoma have been described. Proximal, angiomatoid, and fibroma-like variants have been reported, as have cases displaying significant hyalinization, calcification, and/or ossification. Furthermore, it has long been recognized that epithelioid sarcoma may display focal myxoid change. Herein, the authors describe 2 examples of epithelioid sarcoma that displayed diffuse myxoid change. Both cases were otherwise typical, both morphologically and immunophenotypically, of epithelioid sarcoma. The tumors in both cases were localized, and the patients were treated with wide local excision followed by adjuvant radiotherapy. The patients are free of disease recurrence after 25 and 37 months of follow-up. Differential considerations that may arise because of the composite of morphologic and immunophenotypic findings noted in these cases are discussed, especially if encountered in a small biopsy. These cases further expand the morphologic spectrum of epithelioid sarcoma.