Undifferentiated High Grade Pleomorphic Sarcoma of the Chest Wall: A Rare Entity

Undifferentiated high grade pleomorphic sarcoma is a deep seated pleomorphic soft tissue sarcoma of unknown pathogenesis. It typically occurs in the deep fascia and skeletal muscles of the extremities followed by the trunk and the head and neck. Chest wall is an uncommon site of origin. Chest wall tumors account for less than 1% of all tumors and are classified based on their tissue of origin. They may be primary or secondary and almost both occurring with equal incidence. Most common differential diagnosis of chest wall tumors is generally metastasis from carcinoma of the breast, lung, kidney, thyroid or multiple myeloma arising from ribs. Other differentiated sarcomas with pleomorphic histology which were erroneously classified categorized as malignant fibrous histiocytoma also have diverse prognosis and require exclusion. To the best of our knowledge, few cases of undifferentiated high grade pleomorphic sarcoma, primarily arising from chest wall are noted in the contemporary literature. We report a rare case, this entity arising in the right chest wall of 70 year old gentleman which was successfully treated with aggressive surgery and radiation.