A 50-year-old man presented with a solitary, slow growing mass in the left calf region since two years. The patient gave history of rapid increase in size of the swelling since two months following thorn injury. Magnetic Resonance Imaging (MRI) revealed a large well defined lobulating heterogenous soft tissue malignant neoplasm arising from posteromedial aspect of gastrocnemius muscle extending into subcutaneous plane. Fine Needle Aspiration Cytology (FNAC) of the swelling revealed a low cellular smear with bland spindle shaped cells having moderate amount of cytoplasm, elongated nuclei and inconspicuous nucleoli admixed with anastomosing capillary network and few mature adipocytes in a haemorrhagic background. Based on these findings differential diagnosis of haemangioma or angiolipoma were given.Wide surgical excision of the mass was done and sent for histopathological evaluation. Grossly, the mass measured 13.5 x 12 x 6 cm with an ulcer on the skin surface measuring 6 x 5 cm. On cut surface, circumscribed, firm mass was noted measuring 9 x 5.5 cm, which was predominantly solid having lobulated appearance. Also, seen many blood filled cystic spaces of varying sizes [Table/ Fig-1,2].Microscopically, the lesion was unencapsulated with vascular and cellular areas. Cellularity was variable and it was composed of hyper and hypocellular areas. The tumour tissue in the hyper cellular areas predominantly comprised of spindle shaped cells arranged in interlacing bundles and fascicles, with round to oval vesicular nuclei, inconspicuous nucleoli and moderate amount of eosinophilic cytoplasm. Few pleomorphic cells having vesicular single or multilobated nucleus with prominent nucleoli and abundant eosinophilic cytoplasm were also noted. Few cells showed intranuclear inclusions. Many multinucleated giant cells were also noted. Hypocellular areas were comprised of spindle shaped cells with round to oval nuclei having fine nuclear chromatin and moderate amount of eosinophilic cytoplasm and were dispersed in a myxoid background. These tumour cells were infiltrating the adjacent adipose tissue focally. The vascular areas were comprised of many, large clusters of ectatic thin walled blood vessels. Subendothelial fibrin deposition, organized luminal thrombus and perivascular hyalinization were noted in majority of the vessels. AbStRACtPleomorphic Hyalinizing Angiectatic Tumour (PHAT) is one of the rare soft tissue tumour which is non-metastasizing. The origin of this tumour is yet uncertain. It occurs in adults as a slow growing subcutaneous mass mimicking clinically and histologically to various benign and malignant soft tissue tumours such as schwannoma, haemangioma and malignant fibrous histiocytoma. The microscopic features of this tumour include clusters of ectatic, fibrin containing, hyalinized blood vessels with pleomorphic and spindle shaped tumour cells showing intranuclear inclusions, stromal haemosiderin pigment and a variable inflammatory infiltrate. Despite marked pleomorphism, the lesion behaves as a low grade neo...

Ewing's sarcoma is a highly malignant tumour of osseous or non-osseous origin, tremed as extra-skeletal Ewings sarcoma if arising from soft tissue. It is rare occurrence tumor most commonly occurring in paravertebral area, chest wall, head & neck and retroperitoneum. Reporting an interesting case of retroperitoneal Ewing's sarcoma in 39 years old female. Patient had complains of abdominal discomfort & vague pain since 2 months, following weakness in lower limb and loss of weight. On detail history and examination she was further referred to detail pathological and radiological investigations. Haematological profile, renal function test and liver function test were in normal limits. USG abdomen was normal, MRI showed a mass in pelvis retroperitoneum measuring 10x10cms, bilateral ovaries and tubes were normal. Because of retroperitoneal nature of tumor and suspicion of uterine sarcoma, laparotomy was performed. The large retroperitoneal mass adherent to posterior of uterus was excised and send for histopathological diagnosis. On gross and microscopy examination the diagnosis of blue cell tumor with PAS positivity, possibility of extraskeletal Ewing's sarcoma/primitive neuro-ectodermal tumor was made which was further confirmed by immunohistochemistry, positive for S100, Vementin and CD99 and negative for desmin and CK. Confirmed diagnosis help in accurate management and improves survival rate.

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There are known post thyroidectomized complications, a suture granuloma being less frequent, with its late complication mimi cking recurrent thyroid cancer.A suture granuloma is a benign, granulomatous inflammatory reaction that occurs due to the use of non absorbable suture. It constitutes one of the late complications which altogether make up less than 2% of its incidence.A suture granuloma is similar to a foreign body reaction and it usually develops slowly as a painless, palpable asymptomatic mass over the years. It mimics a cancer recurrence or a lymph node metastasis.Here, we are reporting a case of a post thyroidectomy suture granuloma in a 46 years old lady who presented with a painless swelling in the lateral neck, with a past history of thyroidectomy 5 years back.