Navigating Diagnostic Challenges in Epithelioid Sarcoma: Multidisciplinary Strategies to Optimize Diagnosis
Panelists discuss how recognizing the diagnostic challenges of epithelioid sarcoma (ES)—including its histologic overlap with other conditions and the importance of INI1 loss as a key marker—can improve early detection and reduce misdiagnosis of this rare and aggressive tumor.
Summary for Physicians: Diagnostic Challenges and Pitfalls in ES
Diagnosing ES is often challenging due to its rarity, variable presentation, and histologic overlap with other conditions. Common diagnostic pitfalls include misinterpreting ES as benign lesions such as granulomatous inflammation or reactive processes, especially in the early stages. The tumor’s epithelioid appearance may also lead to misclassification as carcinoma or other soft tissue sarcomas.
Timely diagnosis is complicated by the typically indolent growth of ES, especially in the distal (classic) subtype, which can delay clinical suspicion. The proximal (large cell) subtype can mimic other high-grade sarcomas or poorly differentiated carcinomas due to its more aggressive features and deep-seated location.
ES is frequently misdiagnosed—often initially mistaken for infections, benign cysts, or other sarcoma subtypes. A key diagnostic marker is loss of INI1 (SMARCB1), which should be assessed in cases with ambiguous histology. Awareness of these diagnostic nuances and incorporating molecular testing early in the workup can significantly improve diagnostic accuracy.
Newsletter
Stay up to date on recent advances in the multidisciplinary approach to cancer.
Recap: Recent Advances in the Treatment of Metastatic Castration-Sensitive Prostate Cancer
September 18th 2022Expert oncologists review key studies in the metastatic castration-resistant prostate cancer treatment landscape and discuss how evidence can be applied to clinical practice to improve patient outcomes.
Recap: Updates in Treatment of HER2-Positive Breast Cancer and Brain Metastases
July 16th 2022Sara A. Hurvitz, MD; Stefania Maraka, MD; and Ruta Rao, MD, discuss the evolving landscape of metastatic HER2+ breast cancer, highlighting recent clinical trials and the management of patients with brain metastases.
Recap: Emory Experts Review Treatment Strategies for Transplant-Ineligible Multiple Myeloma
June 20th 2022A panel of experts from Emory University review several key data updates in multiple myeloma from recent meetings and discuss how the data can be applied to clinical practice to improve patient outcomes.
