Select the best ancillary study to confirm the diagnosis.
Fluorescence in situ hybridization (FISH): EWSR1 rearrangement
Fluorescence in situ hybridization (FISH): myc gene amplification
RT-PCR: Detection of the FUS-CREB3L2 fusion product
RT-PCR: Detection of FUS-DDIT3 fusion product
RT-PCR: Detection of COL1A1-PDGFB fusion product
What is the most appropriate therapy for this patient?
Local radiotherapy
Palliative care
Systemic chemotherapy
Wide local excision with careful follow-up
Watchful waiting and reassurance
Acknowledgements
Author Profiles
Lauren N. Stuart
Emory University
Lauren N. Stuart, MD, MBA, is a second-year anatomic and clinical pathology resident at Emory University. She earned a joint MD/MBA degree from the University of Miami. Recently, Dr. Stuart won the first-place award in the ASDP Duel in Dermatopathology for her presentation “Epithelioid sarcoma-like hemangioendothelioma diagnosed by skin biopsy in a 30-year-old male.” In the coming year, she plans to apply for a fellowship in dermatopathology.
Jerad M. Gardner
University of Arkansas for Medical Sciences
Jerad M. Gardner, MD, is an assistant professor at the University of Arkansas for Medical Sciences (UAMS) specializing in both dermatopathology and bone and soft tissue pathology. Dr. Gardner also serves as an associate director of the dermatopathology fellowship program at UAMS. He earned his MD degree from Tulane University and then completed a residency in anatomic and clinical pathology at The Methodist Hospital in Houston, Texas. He then went on to complete a bone and soft tissue pathology fellowship under the direction of Dr. Sharon Weiss at Emory University, followed by a dermatopathology fellowship also at Emory University. Dr. Gardner has a passion for teaching, and plans to create a free soft tissue pathology teaching video series (with a focus on cutaneous spindle cell tumors) for YouTube (www.youtube.com/user/JeradMGardnerMD). He is also the founder and administrator of the Pathology Resident Wiki which has complete lists of all pathology residency and fellowship programs in the United States, including dermatopathology fellowship programs (http://pathinfo.wikia.com/wiki/Dermatopathology_Fellowship_Directory).
Question:
8-year-old boy with subcutaneous nodule of the upper arm