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Case Report
High-grade undifferentiated pleomorphic sarcoma of the colon with node positivity and literature review of current therapeutic targets and future perspectives
1 Department of Internal Medicine, Thomas Hospital Internal Medicine Residency, 750 Morphy Avenue, Fairhope, Alabama 36532, USA
2 Alabama College of Osteopathic Medicine, 445 Health Sciences Boulevard, Dothan, Alabama 36303, USA
3 Department of Surgery, Ascension Sacred Heart Medical Group, 801 E 6th St #606, Panama City, Florida 32401, USA
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Gogo-Ogute E Ibodeng
Department of Internal Medicine, Thomas Hospital Internal Medicine Residency, 750 Morphy Avenue, Fairhope, Alabama 36532,
USA
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Article ID: 101481Z01GI2024
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Ibodeng GOE, Said J, Kwon M, Ra J, Johnson CD, Richards JJ. High-grade undifferentiated pleomorphic sarcoma of the colon with node positivity and literature review of current therapeutic targets and future perspectives. Int J Case Rep Images 2024;15(2):111–116.ABSTRACT
Undifferentiated pleomorphic sarcoma (UPS) arises from mesenchymal tissues and accounts for approximately 1% of adult malignancies. It is the most common type of malignant soft tissue sarcoma, primarily found in the extremities and retroperitoneum, but rarely presents in the gastrointestinal tract. Primary tumors of the mesentery are rare, though metastases to the mesentery from other anatomical sites are frequent. The standard of care of UPS involves surgical resection followed by adjuvant chemotherapy or radiation, though these treatments are often only partially effective.
We report a case of high-grade UPS of the sigmoid colon with node positivity and local extension to the small bowel. The patient underwent an open en bloc resection of the sigmoid colon and small bowel, followed by adjuvant chemotherapy and radiation therapy, resulting in transient clinical improvement. However, the patient returned to the ER 12.5 weeks post-initial surgical resection with complaints of abdominal pain, nausea, vomiting, and diarrhea. An exploratory laparotomy revealed a new intra-abdominal mass, leading to a palliative resection. This case highlights the aggressive nature and poor prognosis of UPS, even with standard treatment. Ongoing clinical trials and emerging therapies are crucial for improving outcomes in UPS. Access to tumor profiling and precision therapies is essential for managing rare cancers like UPS. Further studies and clinical trials are imperative to develop more effective treatments and improve patient prognosis.
Keywords: Malignant fibrous histiocytoma, Metastasis, Sarcoma, Undifferentiated pleomorphic sarcoma
SUPPORTING INFORMATION
Author Contributions
Gogo-Ogute E Ibodeng - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Jaime Said - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Marcus Kwon - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Jennifer Ra - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Christopher D Johnson - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
John J Richards - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2024 Gogo-Ogute E Ibodeng et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
