Localized pleural metastatic adenosarcoma of the uterine cervix mimicking a malignant solitary fibrous tumour: CD10 has no value in differential diagnosis.

Sir: We read with interest the recent work by McCluggage et al. reporting the diagnostic utility of CD10 expression in distinguishing endometrial stromal lesions from other potential mimics, such as uterine smooth muscle neoplasms. CD10 is a cell-surface neutral endopeptidase detected in a variety of normal and neoplastic conditions. However, to the best of our knowledge, CD10 expression has never been investigated in solitary fibrous tumours. We report a large, localized pleural metastatic adenosarcoma of the uterine cervix, that radiologically and morphologically mimicked a malignant solitary fibrous tumour, and evaluate the diagnostic utility of CD10 in this specific setting. The patient, a 57-year-old woman, presented with dyspnoea, non-productive cough, right-sided chest pain and fever. A careful search of the clinical history revealed that the patient had undergone total hysterectomy with bilateral adnexectomy for adenosarcoma of the uterine cervix (FIGO stage Ib), performed 13 years before at another hospital. Physical examination on admission revealed a mild respiratory distress. Routine laboratory studies were unremarkable. Chest radiographs and computed tomography (CT) scan (Figure 1) showed a diffuse atelectasis of the middle and inferior lobes of the right lung, due to the presence of a large, solitary, pleural-based intrathoracic mass that infiltrated the neighbouring structures of the posterior mediastinum. An extensive work-up (total body CT scan and abdomino-pelvic ultrasonography) excluded lesions in other organs. A thoracoscopic biopsy was performed. The patient is alive with progressive local disease 4 months after surgery.