Undifferentiated pleomorphic
sarcoma (UPS) is major type of
soft tissue sarcomas. UPS presenting with
inflammation is rare, and its pathophysiology remains unclear. Herein, we report a rare case of UPS with prolonged
fever. A 91-year-old female complaining of high
fever was referred to our hospital because of a high
C-reactive protein (CRP) level of 12.51 mg/dL. She had been experiencing intermittent
fevers for approximately 10 years. The
fever of unknown origin worsened with time and went into remission with repeated antimicrobial
therapy. She also had a mass on her central lower back over the sacral region for 6 years, which showed a gradual increase in size. The blood tests showed that the leukocyte count and neutrophils were 6.51 × 103 /µL and 70.3%, respectively. She had
a 10 × 10 cm mass on her buttock that showed 2-[
fluorine-18] fluoro-2-deoxy-d-glucose (FDG) accumulation on FDG-positron emission tomography-computed tomography examination (standardized uptake value-max value: 5.4). A blood culture examination was performed to rule out
bacteremia, however, no bacteria were identified. We then performed a needle biopsy and confirmed the diagnosis of UPS; subsequently, the patient underwent a wide-
margin resection. A few days after the surgery, her CRP, leukocyte, and neutrophil levels decreased to 0.305 mg/dL, 2.83 × 103/uL, and 50.1%, respectively. This case demonstrated that UPS with
inflammation should be treated surgically as soon as possible after ruling out other sources of
infection to achieve a favorable prognosis.