Skin & Soft Tissue

Immunohistochemical staining, strongly positive for smooth muscle actin (Courtesy Dr. V. Penopoulos)

Excised leiomyosarcoma of the left shoulder region (Courtesy Dr. V. Penopoulos)

Immunohistochemical staining, strongly positive for vimentin (Courtesy Dr. V. Penopoulos)

Immunohistochemical staining, strongly positive for smooth muscle actin (Courtesy Dr. V. Penopoulos)

Endoanal ultrasonography – Infiltration of the anal canal by the neoplasm. Courtesy Dr. V. Penopoulos.

Gross appearance of the perineum after radical local excision. Courtesy Dr. V. Penopoulos.

Endoanal ultrasonography – Complete regression of the anal neoplasm. Courtesy Dr. V. Penopoulos.

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Cases of peristomal pyoderma gangrenosum (Courtesy Dr. V. Penopoulos)

Excised ulcerative Kaposi lesion and microscopy view (Courtesy Dr. V. Penopoulos)

Non ulcerated Kaposi's Sarcoma lesions on the plantar aspect of the right foot (Courtesy Dr. V. Penopoulos)

Excised ulcerative Kaposi lesion and microscopy view (Courtesy Dr. V. Penopoulos)

The nodule a few centimetres from the left shoulder is evident (Courtesy Dr. V. Penopoulos)

Mediastinal metastases are clearly seen (Courtesy Dr. V. Penopoulos)

Bilateral lung nodules suggestive of melanoma metastases (Courtesy Dr. V. Penopoulos)

Left axillary lymph node ), Ki67 more than 70 Therapeutic intervention (Courtesy Dr. V. Penopoulos)

Giant vulvar cystic tumor (Courtesy Dr. V. Penopoulos)

Hilar metastatic lymph nodes are evident (Courtesy Dr. V. Penopoulos)

Histopathological examination of epidermoid cyst (Courtesy Dr. V. Penopoulos)

Pathological examination of the skin lesion . Hematoxylin-eosin staining showed nests of monomorphic tumor cells with big, atypia, deep stained nucleus, and active mitotic figures but no obvious melanin (Courtesy Dr. V. Penopoulos)

Pathological examination of the skin lesion . Hematoxylin-eosin staining showed nests of monomorphic tumor cells with big, atypia, deep stained nucleus, and active mitotic figures but no obvious melanin (Courtesy Dr. V. Penopoulos)

Gross image of excised cystic tumor (Courtesy Dr. V. Penopoulos)

Complete removal of the lipoma is obvious (Courtesy Dr. V. Penopoulos)

Complete removal of the lipoma is obvious (Courtesy Dr. V. Penopoulos)

Complete removal of the lipoma is obvious (Courtesy Dr. V. Penopoulos)

Lipoma. Remote fat necrosis (FN) with fibrosis and dystrophic calcification . The necrotic adipocytes are devoid of nuclei (Courtesy Dr. V. Penopoulos)

PET Scan : Multiple secondary deposits (Courtesy Dr. V. Penopoulos)

PET Scan : Multiple secondary deposits (Courtesy Dr. V. Penopoulos)

PET Scan : Multiple secondary deposits (Courtesy Dr. V. Penopoulos)

PET Scan : Multiple secondary deposits (Courtesy Dr. V. Penopoulos)

PET Scan : Multiple secondary deposits (Courtesy Dr. V. Penopoulos)

PET Scan : Multiple secondary deposits (Courtesy Dr. V. Penopoulos)

Figure 1 . CT Scan . Sizable tumour in the right buttock . ( Courtesy Dr . V . Penopoulos ) .

Immunohistochemistry: positivity for CD34 in tumoral cells (Courtesy Dr. V. Penopoulos).

Immunohistochemistry positivity for CD99 in tumoral cells (Courtesy Dr. V. Penopoulos).

Figure 3 . Complete excision of the tumour is evident . ( Courtesy Dr . V . Penopoulos ) .

Figure 2 . Cut surface of the excised tumor . (Courtesy Dr . V . Penopoulos) .

). Immunohistochemistry showed a positive reaction to CD34 (fig.3) and CD99 (fig. 4) and negativity to factor XIIIa. The patient was referred to surgical resection and will be accompanied at the ward following the operation (Courtesy Dr. V. Penopoulos).

Figure 2 . Excised tumour – Cut Surface . ( Courtesy Dr . V . Penopoulos ) .

Figure 1 . MRI demonstrated a well circumscribed lesion with predominantly fat equivalent signal intensity . ( Courtesy Dr . V . Penopoulos ) .

Erosion of the sacroiliac joint persisted, demonstrating the destructive characteristics of the neoplasm (Courtesy Dr. V. Penopoulos)

Complete disappearance of the left gluteal mass (Courtesy Dr. V. Penopoulos)

Erosion of the sacroiliac joint persisted, demonstrating the destructive characteristics of the neoplasm (Courtesy Dr. V. Penopoulos)

Immunohistochemical stain for CD20, revealing the presence of large, atypical, lymphoid cells on the membrane (Courtesy Dr. V. Penopoulos)

Hematoxylin-eosin stain. Diffuse infiltration of large atypical lymphoid cells with prominent nucleoli (Courtesy Dr. V. Penopoulos)

Figure 2 . Macroscopic view of the excised fibromyxoid sarcoma . (Courtesy Dr . V . Penopoulos) .

Figure 3 . Surgical field following excision of sarcoma . (Courtesy Dr . V . Penopoulos) .

Abdominal CT Scan. February 2017. The retroperitoneal angiosarcoma recurrence is shown (red arrows)

Left colectomy specimen

Excised recurrent retroperitoneal Epithelioid angiosarcoma

Excised Small bowel metastases

Lumbar MRI — The lesion is clearly confined to the skin and subcutaneous tissue (Courtesy Dr. V. Penopoulos)

Erythematous, firm, ulcerated, bleeding, broad-based lumbar lesion (Courtesy Dr. V. Penopoulos)

Lumbar MRI — The lesion is clearly confined to the skin and subcutaneous tissue (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Purple arrows: lipomas. Brown arrow: sebaceous gland adenocarcinoma (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Sheets/layers and nodules of infiltrating basaloid germinative cells, with areas of squamous differentiation, necrosis, and focal neutrophilic microabscesses (Courtesy Dr. V. Penopoulos)

Purple arrows: lipomas. Brown arrow: sebaceous gland adenocarcinoma (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Extensive sebaceous differentiation of the neoplastic cells throughout the lesion with distinct sebaceous nodules and foci of apoptosis and necrosis within the tumor islands. The neoplastic cells show marked mitotic activity (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Purple arrows: lipomas. Brown arrow: sebaceous gland adenocarcinoma (Courtesy Dr. V. Penopoulos)

Purple arrows: lipomas. Brown arrow: sebaceous gland adenocarcinoma (Courtesy Dr. V. Penopoulos)

Immunohistochemical examination – Positivity for HMB45 marker (Courtesy Dr. V. Penopoulos)

Immunohistochemical examination – Positivity for HMB45 marker (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Histopathological examination revealing the presence of plump, spindle-shaped cells with prominent nuclei and melanin pigment (Courtesy Dr. V. Penopoulos)

Hematoxylin and eosin stain. Presence of scattered atypical mitotic figures, necrotic tumor cells, and typical sebaceous differentiation with vacuolated cytoplasm and wavy nuclear contours (Courtesy Dr. V. Penopoulos)

Multiple pulmonary metastases (Courtesy Dr. V. Penopoulos)

MRI of the femoral inguinal fold with contrast, demonstrating a soft-tissue mass arising from the great saphenous vein (Courtesy Dr. V. Penopoulos)

Multiple pulmonary metastases (Courtesy Dr. V. Penopoulos)

Multiple pulmonary metastases (Courtesy Dr. V. Penopoulos)

Multiple pulmonary metastases (Courtesy Dr. V. Penopoulos)

Multiple pulmonary metastases (Courtesy Dr. V. Penopoulos)

Macroscopic image of the excised cystic tumor (Courtesy Dr. V. Penopoulos)

Epithelioid cells with moderate pleomorphism, eosinophilic cytoplasm, prominent vesicular nuclei, sparse rhabdoid cells and hyaline inclusions in the cytoplasm, which displace the nuclei eccentrically (Courtesy Dr. V. Penopoulos)

Multiple brain metastases (Courtesy Dr. V. Penopoulos)

Multiple pulmonary metastases (Courtesy Dr. V. Penopoulos)

Epithelioid and rhabdoid cells showing positivity for vimentin and cytokeratin (Courtesy Dr. V. Penopoulos)

Histopathological examination of the epidermoid cyst (Courtesy Dr. V. Penopoulos)

Giant cystic tumor of the vulva (Courtesy Dr. V. Penopoulos)

Extended right hemicolectomy specimen (Courtesy Dr. V. Penopoulos)

Figure 5 . Purulent Hidradenitis. Abscesses , draining sinuses and scarring . (Courtesy Dr . V . Penopoulos ) .

Part of peritonectomy specimen (Courtesy Dr. V. Penopoulos)

Histopathology images of pseudomyxoma (Courtesy Dr. V. Penopoulos)

Figure 6. Excised axillary disease. (Courtesy Dr. V.Penopoulos).

Figure 4 . Purulent Hidradenitis. (Courtesy Dr . V . Penopoulos ) .

Figures 1 , 2 , 3 . Hidradenitis suppurativa . ( Courtesy Dr . V . Penopoulos ) .

Excised greater omentum (Courtesy Dr. V. Penopoulos)