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Skin diseases of the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
Microcystic adnexal carcinoma (MAE) is a locally aggressive cutaneous neoplasm found especially in women and has follicular and sweat gland differentiation. It involves the face, especially the upper lip and periorbital areas. It is neurotropic and rarely if ever metastasizes. Malignant fibrous histiocytoma is the most common soft tissue sarcoma of late adult life; it favors males appearing most commonly on the thighs and lower extremities. It is flesh-colored and is occasionally ulcerated. It may complicate chronic ulcers, burn scars, surgical and irradiation sites. Metastasis occurs within 2 years. Atypical fibroxanthoma is a low-grade malignancy occurring in sun-exposed areas of the head and neck of the elderly. Because of its relatively small size and superficial origin it has a more favorable prognosis.
Phenotypic Heterogeneity of the Dermal Monocyte/Macrophage System
Published in Brian J. Nickoloff, Dermal Immune System, 2019
Wolfram Sterry, Wolf-Henning Boehncke
Atypical fibroxanthoma64 is a tumor of unclear descendence. Its histopathologic features comprise an admixture of fibroblasts, histiocyte-like cells, xanthomatous cells, and multinucleated giant cells. Cases investigated clearly were Ki-M1P+. This immunophenotype suggests a macrophage origin of the tumor.
Tumors of Fibrous Tissue
Published in Omar P. Sangueza, Sara Moradi Tuchayi, Parisa Mansoori, Saleha A. Aldawsari, Amir Al-Dabagh, Amany A. Fathaddin, Steven R. Feldman, Dermatopathology Primer of Cutaneous Tumors, 2015
Atypical fibroxanthoma is a low-grade sarcoma that occurs in sun-damaged skin of the head and neck of elderly patients. Atypical fibroxanthoma is considered to be a superficial form of malignant fibrous histiocytoma.
An uncommon presentation of a cutaneous angiosarcoma
Published in Acta Chirurgica Belgica, 2021
Nicholas O. Wilssens, Margot Den Hondt, Jolien Duponselle, Raf Sciot, Daphne Hompes, Thomas H. G. Nevens
As clinical diagnosis of cAS is challenging, especially in the early stages, physicians often rely on the histopathology. Unfortunately, the pathological diagnosis of angiosarcoma can be very challenging, certainly on a small biopsy. Classical differential diagnoses are traumatized capillary hemangioma, Kaposi sarcoma, spindle cell hemangioma, atypical vascular lesion, hemangioendothelioma, melanoma, carcinoma and atypical fibroxanthoma [5]. Because these lesions imply very different treatment strategies, misdiagnosis may have important clinical implications. In the case presented here a punch biopsy was performed at first presentation of the patient in the outpatient clinics, but this could not reveal any signs of malignancy. It was not until several months later that the third (deep) biopsy eventually suggested a cAS. By that time however, the clinical appearance had become overtly suspicious. The finding of focal infiltrative margins, the presence of D2-40 and mainly of the proto-oncogene MYC indicated the presence of malignancy. These findings are consistent with the literature [5,6].
Superficial CD34-Positive Fibroblastic Tumor on the Chest Wall of an 8-Year-Old Girl: A Case Report and Literature Review
Published in Pediatric Hematology and Oncology, 2021
Si Ying Li, Hai Lan Zhang, Yu Zuo Bai
It has been suggested that SCPFT may be less rare than considered, and raising awareness may assist in more accurate pathological diagnosis.2 As a new tumor in the family of CD34-positive spindle cell stromal tumors, the importance of its identification is to avoid confusion with other polymorphic soft tissue tumors of the skin. In particular, especially for children, unnecessary or excessive treatment may be caused if patients are misdiagnosed with highly undifferentiated tumors. In clinical practice, SCPFT usually needs to be distinguished from high-grade polymorphic sarcoma, myxofibrosarcoma, atypical fibroxanthoma (AFX), dermatofibrosarcoma protuberans (DFSP), giant cell fibroblastoma (GCF) and polymorphism dermis sarcoma (PDS). Ki-67 shows higher labeling index in myxofibrosarcoma.6 TP53 is excessively expressed in high-grade polymorphism sarcoma, myxofibrosarcoma, and AFX; however, it is not expressed in SCPFT.6,7 CD34 is not expressed in AFX, which has active atypical mitosis. PDS has the same cell morphology but larger tumor volume compared to AFX.7 The rearrangement of PDGFB is positively in DFSP and GCF.16 Lao et al (2017) pointed out that the SCPFT cases tested by FISH did not show a rearrangement in the PDGFB and that is consistent with our results.2 Puls et al (2019) found that not all patients diagnosed with SCPFT have rearrangement of PRDM10.18 In present case, the rearrangement of PRDM10 was negative. To determine whether PRDM10-rearranged soft tissue tumors should be considered as a subset of SCPFT or as a standalone entity, a larger series of studies is needed.18