S. Kima (Prof), J. Ha*b (Prof), H. Kimb (Prof), J. Choib (Prof)

a The Catholic University of Korea, St. Vincent’s Hospital, Suwon, KOREA, REPUBLIC OF ; b The Catholic University of Korea, Incheon St. Mary’s Hospital, Incheon, KOREA, REPUBLIC OF

* aescylus@catholic.ac.kr


Clear cell sarcoma (CCS) is a rare soft tissue sarcoma subtype that usually develops in the deep soft tissues of the lower extremities and has features of both melanoma and soft tissue sarcoma. We report a case of clear cell sarcoma which was diagnosed by medical thoracoscopic biopsy appeared as black metastatic pleural nodules.

Case report

A 41-year-old male without any underlying disorder was admitted via emergency room for pleural chest pain and dyspnea. Multiple black clolored pleural nodules, masses and thickenings were observed on medical thoracoscopy and multiple biopsies were performed. The frozen section result was malignant with black pigmentation and talc pleurodesis was done. Also, there was a non-black mass of 5cm on the sole of the left foot, so a punch biopsy was performed. The pathologic finding showed spindle cell tumor with melanocytic differentiation. EWSR1 gene translocation was positive and therefore we diagnosed this patient as a primary clear cell sarcoma metastasized to the pleura from the left foot.


This case was meaningful in that a very rare disease requiring differentiation from melanoma, was diagnosed by confirming black metastatic nodules by medical thoracoscopy.

Disclosure of funding source(s): none