case_images: PMC6207953_01
case_images: Right leg lymphedema, sero-hemorrhagic drainage, notice extensive fibrinous and eschar tissue (before debridement and antibiotic therapy).
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case_images: Physical examination revealed chronic changes of elephantiasis, specifically verrucous skin, with a noticeable serosanguinous foul-smelling discharge, more prominent on the right than the left leg (Figures 1 and 2).
case_images: Right leg 1-week after debridement and under broad-spectrum intravenous antibiotic therapy.
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case_images: Physical examination revealed chronic changes of elephantiasis, specifically verrucous skin, with a noticeable serosanguinous foul-smelling discharge, more prominent on the right than the left leg (Figures 1 and 2). A 2-week follow-up visit revealed some improvement in the odor and discharge; however, vascular-like lesions were now more obvious on both of his legs (Figure 2), and a punch biopsy was taken.
case_images: Highly atypical and pleomorphic neoplastic cells form solid aggregations and rudimentary vascular structures (H&E, upper) and strongly express CD31 (immunostaining, lower).
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case_images: The histopathology report depicted an extensive infiltrate of the dermis with small irregular aggregations of the highly atypical and pleomorphic cells (Figure 3).
case_images: These atypical cells strongly express CD31 immunostaining (lower), and stained positively for vimentin, CD34 typical of epithelioid sarcoma (angiosarcoma) but negative for Kaposi sarcoma-associated human herpesvirus-8 (HHV-8), pankeratin (AE1/AE3), p63, CK7, CK20, S100, SOX10 and CD45.
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case_images: PMC6207953_01_10.1177_2050313X18796343-fig4.jpg
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case_images: These atypical cells stained positively for vimentin, CD31 (Figure 4) and, CD34, typical of epithelioid sarcoma (angiosarcoma) but negative for human herpesvirus-8 (HHV-8).