Epithelioid sarcoma differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]

Overview

Epithelioid sarcoma must be differentiated from synovial sarcoma, wart, ganglion cysts, rhabdomyosarcoma, and clear cell sarcoma.

Differentiating Epithelioid sarcoma from other Diseases

• Synovial sarcoma
• Ulcerating squamous cell carcinoma
• Granulomatous diseases
• Traumatic wound
• Wart
• Ganglion cysts
• Giant cell tumors
• Rhabdomyosarcoma
• Clear cell sarcoma
• Vascular sarcoma

	Keratin	CD34	Cytoplasm	In-sutu Kerataniztion	Location	Age group	H/O of epithelial injury	CA125	CK5/6	GCDFP15, S100, actin	Necrosis	Calcification	Hemangiopericytomatous vessels
Epitheloid Sarcoma	Positive	Positive	Sharply defined	Negative	Hand and wrist	Under 40 years	No	Positive	Rare, Local	Negative	Extensive	Infrequent	Negative
Palisaded Necrotic Granuloma	Neagtive	Negative	Indistinct		Uncommon
Squamous Carcinoma		Negative		Positive		>40	Positive	Negative in cutaneous SCC Positive everywhere	Extensive
Sweat Gland Carcinoma		Negative								Positive
Monophasic Synovial Sarcoma		Negative						Negative			Focal	Frequent	Positive
Melanoma	Negative	Negative						Negative		Positive
Epithelioid Hemangioendothelioma	Negative				Uncommon on extremities
Sclerosing Epithelioid Fibrosarcoma	Negative		Cords of cells in hylainzed stroma
Ischemic Fasciitis	Negative		Basophilic or amphophilic