A soft tissue sarcoma of thigh presenting with an extensive heterotopic ossification - A rare case report

Abstract

Background: Various tumorous and non-tumorous aetiologies are associated with massive calcification outside the bone. Case report: In this article, we discuss the bizarre presentation of a sarcomatous lesion in a 72-year-old man having a chief complaint of sudden onset of pain in a chronic swelling in his right thigh. Magnetic Resonance Imaging of the swelling was suggestive of three unrelated possibilities i.e. intramuscular soft tissue tumor, myositis ossificans, and, tumoral calcinosis. Biopsy was performed and histopathology findings revealed it to be a vascular tumor with two possibilities (a) Epithelioid hemangioendothelioma which is a vascular tumor with intermediate malignant potential and a strong propensity to metastasize and (b) Angiosarcoma. The patient refused further molecular studies or medical/surgical management and died of metastatic disease a few months later. Conclusion: The possibility of a soft tissue sarcoma should be considered despite the protracted course and benign-looking imaging.

Keywords

• Calcification
• Calcified
• Epitheloid hemangioendothelioma
• Tumoral calcinosis
• Synovial sarcoma
• Vascular tumor