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Background <p>Extraskeletal osteosarcoma (ESOS) is a rare high-grade malignant mesenchymal tumor that produces osteoid in soft tissue without skeletal involvement. Subcutaneous ESOS is exceptionally uncommon and may mimic benign soft tissue lesions.</p> Case presentation <p>A 45-year-old Samoan man presented with a one-year history of a progressively enlarging, painless left gluteal mass. Contrast-enhanced CT showed a well-circumscribed subcutaneous lesion measuring 9.1 × 10.4 × 8.6 cm, with mild to moderate delayed enhancement and no osseous involvement. The tumor was surgically excised. Histopathology showed a spindle to pleomorphic high-grade sarcoma with osteoid produced by atypical tumor cells. Immunohistochemistry showed SATB2 positivity and negative staining for S100, SOX10, pan-cytokeratin, and ERG. The tumor involved the deep resection margin, consistent with R1 resection; the closest margin distance was not specified. The patient declined adjuvant therapy and was subsequently lost to follow-up.</p> Conclusions <p>Subcutaneous ESOS is rare and diagnostically challenging. This case highlights the importance of imaging, histopathology, immunohistochemistry, and multidisciplinary management, particularly in resource-limited settings.</p>

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Subcutaneous extraskeletal osteosarcoma of the gluteal region: a case report from a resource-limited setting

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月19日

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  • Yan Feng,
  • Aleki Fuimaono,
  • Sione Pifeleti,
  • Seventeen Toumoua,
  • Tieying Zhang,
  • Yan Liang,
  • Xu Ding

摘要

Background

Extraskeletal osteosarcoma (ESOS) is a rare high-grade malignant mesenchymal tumor that produces osteoid in soft tissue without skeletal involvement. Subcutaneous ESOS is exceptionally uncommon and may mimic benign soft tissue lesions.

Case presentation

A 45-year-old Samoan man presented with a one-year history of a progressively enlarging, painless left gluteal mass. Contrast-enhanced CT showed a well-circumscribed subcutaneous lesion measuring 9.1 × 10.4 × 8.6 cm, with mild to moderate delayed enhancement and no osseous involvement. The tumor was surgically excised. Histopathology showed a spindle to pleomorphic high-grade sarcoma with osteoid produced by atypical tumor cells. Immunohistochemistry showed SATB2 positivity and negative staining for S100, SOX10, pan-cytokeratin, and ERG. The tumor involved the deep resection margin, consistent with R1 resection; the closest margin distance was not specified. The patient declined adjuvant therapy and was subsequently lost to follow-up.

Conclusions

Subcutaneous ESOS is rare and diagnostically challenging. This case highlights the importance of imaging, histopathology, immunohistochemistry, and multidisciplinary management, particularly in resource-limited settings.