Cutaneous postirradiation sarcoma. Ultrastructural evidence of pluripotential mesenchymal cell derivation.

A 75-year-old man developed synchronous multicentric cutaneous sarcomas and basal cell carcinoma of the face 57 years after receiving irradiation for acne. During the previous 30 years he had been treated many times for actinic keratoses and basal cell carcinomas. Surgical treatment had included total nasectomy, excision, and replacement of the skin of the upper and lower lips and the chin. Due to the multiplicity of morphologic patterns, it was difficult to subtype the sarcomas. Ultrastructural studies showed histiocyte-like, fibroblast-like and vasoformative cells suggesting an origin from a pluripotential mesenchymal stem cells.