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852 A rare case of pleomorphic dermal sarcoma presented during pregnancy, a case report
  1. Daniel Milkovski1,
  2. Marjan Stojovski1,
  3. Viktorija Jovanovska1,
  4. Vlatko Gjirevski1,
  5. Ivana Kijajova1,
  6. Maja Koteva1,
  7. Slagjana Simeonova Krstevska1,
  8. Ivo Kjaev1,
  9. Darko Andonovski2 and
  10. Romir Kadriu1
  1. 1University Clinic of Obstetrics and Gynecology, Skopje, North Macedonia
  2. 2PZU Dr. Andonovski, Probishtip, Macedonia, Former Yugoslav Republic of


Introduction/Background Soft tissue sarcomas are rare tumors arising in mesenchymal tissues and can occur almost anywhere in the body. They are rarely diagnosed during pregnancy. Pleomorphic dermal sarcoma (PDS) are dermal-based malignant tumors that usually present on sun-exposed sites of elderly patients and are morphologically similar to atypical fibroxanthoma (AFX). PDS is considered an aggressive cancer and likely to metastasize and reappear. Early detection and aggressive treatment improve outcomes.

Methodology A case report

Results A 24-year-old female presented during her (26) GW with right inguinal pain. A solid 2cm painful bump was palpated, with no skin lesions. Foetal Ultrasound and vaginal examination were normal. She was advised to follow up with a haematologist and a surgeon, which she failed to do. One month later, she presented again with the red painful lump noticeably enlarged to 7cm. MRI results suspected a package of infiltrated enlarged lymph nodes or neoplasms of primary or secondary character. She had the tumor completely surgically excised. Histopathological findings showed a 8cm Pleomorphic dermal sarcoma (PDS). At 33 GW she was admitted for corticosteroid therapy for maturation of the foetal lungs, upon which she had a C-section. She was later referred to Oncology for chemotherapy.

Conclusion PDS tumors usually present as painless, regular rapidly growing red bumps or nodules on the skin or subcutaneously. Diagnosis is with examination, dermoscopy, punch biopsy and imaging techniques. Treatment is surgical with ensuring clear margins, followed by immunotherapy and chemotherapy. Systematic chemotherapy should be avoided during the 1st trimester of pregnancy due to lethal and teratogenic effects. During the 2nd and 3rd trimester certain chemotherapeutic drugs can be administered. Radiotherapy cannot be applied due to its lethal effect on the fetus. Hormonal and targeted treatments should not be advised

Disclosures No conflicts of interest are reported.

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