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Lencastre A, Arnal C, Richert B. Surgery for benign nail tumor. HAND SURGERY & REHABILITATION 2024; 43S:101651. [PMID: 38296187 DOI: 10.1016/j.hansur.2024.101651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 02/13/2024]
Abstract
The vast majority of tumors in the nail apparatus have a different clinical presentation and course from their equivalents on the skin. Some, such as onychomatricoma and onychopapilloma, are unique to the nail and others, such as superficial acral fibromyxoma, have a tropism for the nail apparatus. As a rule, benign lesions respect the general architecture of the nail apparatus, whereas malignant tumors are destructive. Treatment is always surgical and good knowledge of the anatomy and the procedures is mandatory in order not to induce postoperative nail dystrophy.
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Affiliation(s)
| | - Charlotte Arnal
- Dermatology Department, Université Libre de Bruxelles, Brugmann University Hospital, Saint-Pierre University Hospital and Queen Fabiola Children's Hospital, Brussels, Belgium
| | - Bertrand Richert
- Dermatology Department, Université Libre de Bruxelles, Brugmann University Hospital, Saint-Pierre University Hospital and Queen Fabiola Children's Hospital, Brussels, Belgium.
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Chiheb S, Mouradi M, Hali F. Superficial Acral Fibromyxoma: Clinicopathologic Analysis of Five Cases. Skin Appendage Disord 2021; 7:468-474. [PMID: 34901178 DOI: 10.1159/000516302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/10/2021] [Indexed: 11/19/2022] Open
Abstract
Superficial acral fibromyxoma is a relatively rare benign slow-growing soft-tissue tumor, first described by Fetsch's group [Hum Pathol. 2001;32:704-14]. Since then, around three hundred publications have concerned this relatively new entity. The tumor involves peri- and subungual regions of fingers and toes in middle-aged adults with slight male predominance. This acral fibrous tumor is poorly known, and in certain cases, histology results may suggest myxoid dermatofibrosarcoma, which carries a completely different prognosis. In this article, we discuss the clinicopathologic features of this acral fibrous tumor through the report of 5 cases including 1 particular clinical presentation that revealed as a retronychia in a young woman.
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Affiliation(s)
- Soumiya Chiheb
- Department of Dermatology Venerology, Hospital Ibn Rochd University Hassan II, Casablanca, Morocco
| | - Maha Mouradi
- Department of Dermatology Venerology, Hospital Ibn Rochd University Hassan II, Casablanca, Morocco
| | - Fouzia Hali
- Department of Dermatology Venerology, Hospital Ibn Rochd University Hassan II, Casablanca, Morocco
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Crepaldi BE, Soares RD, Silveira FD, Taira RI, Hirakawa CK, Matsumoto MH. Superficial Acral Fibromyxoma: Literature Review. Rev Bras Ortop 2019; 54:491-496. [PMID: 31736517 PMCID: PMC6856000 DOI: 10.1016/j.rbo.2017.10.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 10/31/2017] [Indexed: 11/17/2022] Open
Abstract
Superficial acral fibromyxoma is a benign and rare tumor of the soft tissues. It usually manifests itself through a painless mass of slow growth that affects mainly males in the fifth decade of life. It usually affects the distal region, with a polypoid or dome-shaped appearance. The histological appearance is of a dermal mass without capsule, with spindle-shaped fibroblasts in a storiform or fasciculated pattern in the myxocollagenous stroma. The immunohistochemical evaluation of superficial acral fibromyxoma is usually positive for CD34 and CD99, with variable positivity for epithelial membrane antigen. The treatment consists of complete excision of the tumor mass. A review of the current literature on superficial acral fibromyxoma was performed, with an emphasis on the number of cases reported, location, diagnostic methods, histological characteristics, differential diagnoses and treatment. A total of 314 reported cases of superficial acral fibromyxoma with variable locations were found in the current literature, mainly in the toes (45.8%) and fingers (39.1%). It has a slightly superior incidence in men (61%) and enormous variability in the age range of occurrence. Superficial acral fibromyxoma is a single soft-tissue tumor that should enter the differential diagnosis of periungual and subungual acral lesions; the treatment consists of simple excision. More studies are needed to better understand this pathology, which was first described in 2001.
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Affiliation(s)
- Bruno Eiras Crepaldi
- Grupo de Cirurgia da Mão e Microcirurgia, Hospital Santa Marcelina de Itaquera, São Paulo, SP, Brasil
| | - Ruan Dalbem Soares
- Grupo de Cirurgia da Mão e Microcirurgia, Hospital Santa Marcelina de Itaquera, São Paulo, SP, Brasil
| | - Fábio Duque Silveira
- Grupo de Cirurgia da Mão e Microcirurgia, Hospital Santa Marcelina de Itaquera, São Paulo, SP, Brasil
| | - Raul Itocazo Taira
- Grupo de Cirurgia da Mão e Microcirurgia, Hospital Santa Marcelina de Itaquera, São Paulo, SP, Brasil
| | - Celso Kiyoshi Hirakawa
- Grupo de Cirurgia da Mão e Microcirurgia, Hospital Santa Marcelina de Itaquera, São Paulo, SP, Brasil
| | - Marcelo Hide Matsumoto
- Grupo de Cirurgia da Mão e Microcirurgia, Hospital Santa Marcelina de Itaquera, São Paulo, SP, Brasil
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Fibromyxoma of the Orbit. J Craniofac Surg 2018; 30:e19-e21. [PMID: 30444783 DOI: 10.1097/scs.0000000000004950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Fibromyxomas are rare tumors that are not commonly seen in the orbit. The authors present a case of orbital fibromyxoma. A 42-year-old male presented with proptosis of the right eye that began 1 month prior. Magnetic resonance imaging revealed the presence of an orbital mass in the right eye, with low signal intensity on T1-weighted images and heterogeneous high-signal intensity on T2-weighted images. The patient underwent excisional biopsy of the orbital tumor through a Krönlein approach. The tumor originated from the inferior rectus muscle. Histopathologic analysis demonstrated scattered spindle cells, with both fibrous and myxoid stroma. Immunohistochemical staining was positive for Vimentin and negative for S-100 protein and CD34. The tumor was diagnosed as orbital fibromyxoma. The patient showed no evidence of recurrence over 18 months of follow-up after operation.
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Abstract
A 61-year-old woman presented with a slow-growing mass on the right upper eyelid. The hard, fixed, and nontender mass was apparent on the right upper eyelid. It was immobile, and it seemed to be adhered to the tarsus. Total excision of the mass was performed. A histopathological examination revealed a solid mass with fibrous and myxoid areas with scattered spindle- to stellate-shaped cells in a fibromyxoid matrix. The immunochemistry examination stained positively for CD34 and CD99. Based on these findings, the lesion was diagnosed as a tarsal fibromyxoma. Although rare, a fibromyxoma originating from the tarsus should be considered in the differential diagnosis of solid tarsal lesions.
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Chabbab F, Metz T, Saez Beltran L, Theunis A, Richert B. [Superficial acral fibromyxoma in a sub-matricial location: An unusual variant]. Ann Dermatol Venereol 2014; 141:94-105. [PMID: 24507203 DOI: 10.1016/j.annder.2013.10.056] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/29/2013] [Accepted: 10/29/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND Superficial acral fibromyxoma (SAFM) is a benign soft tissue tumor located in the acral areas, particularly the peri- and sub-ungueal areas. Sub-matricial localisations have not been reported to date. PATIENTS AND METHODS We report herein the clinical and pathological presentation of three cases of SAFM located solely under the matrix. The patients presented with pseudo-clubbing, onychogryphosis or triangular macrolunula. The histopathological appearance was characteristic. DISCUSSION SAFM is a slow-growing, skin-colored, firm nodule, located chiefly on the digits or the toes, and especially in the nail area. It may or may not be painful. Microscopically, it presents as a relatively well-circumscribed but unencapsulated dermal tumor, composed of spindle shaped cells integrated in a myxocollagenic matrix, sometimes invading the subcutis. Tumor cells diffusely express CD34. A conservative surgical approach is recommended. Both clinicians and pathologists should be aware of this entity in order to avoid misdiagnosis, which can lead to unwarranted mutilating surgery. CONCLUSION Sub-matricial localisation of SAFM is extremely rare and may present as pseudo-clubbing, isolated onychogryphosis or a triangular macrolunula. A conservative surgical approach should be recommended.
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Affiliation(s)
- F Chabbab
- Service de dermatologie, CHU Ibn Rochd, 1, rue des Hôpitaux, 20360 Casablanca, Maroc
| | - T Metz
- Département inter-hospitalier de dermatologie-vénéréologie, CHU Brugmann, Saint-Pierre et hôpital universitaire des enfants Reine-Fabiola, université libre de Bruxelles, 4, place Van-Gehuchten, 1020 Bruxelles, Belgique
| | - L Saez Beltran
- Département inter-hospitalier de dermatologie-vénéréologie, CHU Brugmann, Saint-Pierre et hôpital universitaire des enfants Reine-Fabiola, université libre de Bruxelles, 4, place Van-Gehuchten, 1020 Bruxelles, Belgique
| | - A Theunis
- Département inter-hospitalier de dermatologie-vénéréologie, CHU Brugmann, Saint-Pierre et hôpital universitaire des enfants Reine-Fabiola, université libre de Bruxelles, 4, place Van-Gehuchten, 1020 Bruxelles, Belgique; Département d'anatomie pathologique, Bordet Cancer Institute, université libre de Bruxelles, 121, boulevard de Waterloo, 1000 Bruxelles, Belgique
| | - B Richert
- Département inter-hospitalier de dermatologie-vénéréologie, CHU Brugmann, Saint-Pierre et hôpital universitaire des enfants Reine-Fabiola, université libre de Bruxelles, 4, place Van-Gehuchten, 1020 Bruxelles, Belgique.
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Souza BGSE, Lisboa TP, Barbosa VAK, Almeida JPSD, Bacchi CE, Souza VG. Superficial Acral Fibromyxoma of the Thumb: A Case Report. Rev Bras Ortop 2013; 48:200-203. [PMID: 31211129 PMCID: PMC6565865 DOI: 10.1016/j.rboe.2012.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2012] [Accepted: 07/17/2012] [Indexed: 11/15/2022] Open
Abstract
The authors report a case of superficial acral fibromyxioma (SAF) in a 74-year-old male who presented with a painless mass in a periungual dorsoradial region of the right thumb. It is a rare benign neoplasm, which was recently described, that arouse on the skin and subcutaneous tissue of the hands and feet, especially in the proximity to the ungual region of male adults. Surgical treatment was performed with the excision in blocks of the margins of the lesion and fragmentation of the nail and nail matrix, according to the literature recommendation. Although there may be local recurrence in 22% of the cases, the patient presents no symptoms, deformities or functional limitations. In addition, there was no sign of tumor recurrence 18 months after the surgery. We are not aware of a similar case report in the Brazilian literature.
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Affiliation(s)
| | - Tales Pereira Lisboa
- Undergraduate Medical Student at Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | | | - Carlos Eduardo Bacchi
- PhD in Medicine; Full Professor at Universidade Estadual Paulista (Unesp) de Botucatu; Pathologist at Laboratório Bacchi, Pathology Consultancy, Botucatu, SP, Brazil
| | - Valter Gonçalves Souza
- Orthopedist and Traumatologist and Head of the Orthopedics and Traumatology Service, Hospital de Misericórdia de Santos Dumont, Santos Dumont, MG, Brazil
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Schroder e Souza BG, Lisboa TP, Barbosa VAK, Almeida JPSD, Bacchi CE, Souza VG. Fibromixoma acral superficial do polegar: relato de caso. Rev Bras Ortop 2013. [DOI: 10.1016/j.rbo.2012.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Abstract
Primary tumors of the lacrimal sac are extremely rare and predominantly epithelial in origin. We report a unique case of fibromyxoma of the lacrimal sac in an 86-year-old Caucasian woman who presented with 3 months of lower eyelid edema and 1 week of purulent discharge, epiphora, and acute pain. Examination revealed right lower eyelid erythema/edema and a tender, firm, palpable mass of the right lacrimal sac, which self-expressed a yellow, purulent discharge. On surgical exploration, a firm, rubbery, yellow mass was encountered and excised. Histopathologic analysis identified a nonencapsulated mass composed of loose interlacing fascicles and bundles of spindle-shaped cells with prominent myxoid changes; immunostaining was strongly positive for vimentin, weakly for smooth muscle actin, and negative for S-100 and muscle-specific actin. These findings were consistent with the diagnosis of a fibromyxoma of the lacrimal drainage system. After excision, the patient did well, with resolution of dacryocystitis.
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