The most common sarcoma of the skin is a pleomorphic sarcoma. It can also be called an undifferentiated pleomorphic sarcoma. The most common skin sarcoma is a malignant fibrous histiocytoma (MFH). These lesions can be confused with an atypical fibroxanthoma (AFX). AFX tends to appear as a dermal nodule without significant skin change on the surface, while sarcoma or MFH presents as an ulcerating nodule due to its aggressive growth. Skin sarcomas like all sarcomas are highly aggressive with ability to spread through angioinvasion, perineural invasion, and lymphatic spread. These lesions also have a tendency of exhibiting intradermal skip areas with dermal metastases. Treatment of skin sarcomas involve wide local resection, followed by radiation. Lymph node evaluation with either sentinel lymph node biopsies or lymphadenectomies can aid in staging the cancer.
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