1
|
Lee KH, Lee SY, Lim B, Park K. A Case of Solitary Fibrous Tumor on the Foot. Ann Dermatol 2023; 35:S176-S177. [PMID: 37853904 PMCID: PMC10608379 DOI: 10.5021/ad.21b.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 10/19/2021] [Accepted: 11/05/2021] [Indexed: 10/20/2023] Open
Affiliation(s)
- Ki Hun Lee
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Seung Yeon Lee
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Bora Lim
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea
| | - Kun Park
- Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea.
| |
Collapse
|
2
|
Vincek V, Kallis P, Vause A, Vincek E, Ilkovitch D, Motaparthi K. Cutaneous solitary fibrous tumor: Report of three cases with review of histopathological mimics. J Cutan Pathol 2021; 49:167-171. [PMID: 34569103 DOI: 10.1111/cup.14138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 11/26/2022]
Abstract
Solitary fibrous tumor (SFT) is a relatively uncommon spindle cell mesenchymal neoplasm that is most often based on the pleura but may rarely arise in extrapleural locations, including the skin. Herein, we describe three cases of cutaneous SFTs. SFT is characterized by epithelioid and spindle cells arranged in random patterns with focal prominent stromal collagen and pericytomatous vessels. Immunohistochemical evaluation is required for definitive distinction of SFT from other benign and malignant cutaneous spindle cell neoplasms. Although aggressive biologic behavior is uncommon, accurate diagnosis of it is required for prognostication and counseling. CD34, bcl-2, and CD99 stains are positive in SFT, but not specific. STAT6 is the most sensitive and specific immunohistochemical marker to confirm diagnosis of SFT.
Collapse
Affiliation(s)
- Vladimir Vincek
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Penelope Kallis
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Ava Vause
- The Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, Connecticut, USA
| | - Erik Vincek
- The Frank H. Netter M.D. School of Medicine, Quinnipiac University, North Haven, Connecticut, USA
| | | | - Kiran Motaparthi
- Department of Dermatology, College of Medicine, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
3
|
Abstract
While superficial (cutaneous/subcutaneous) solitary fibrous tumor (SFT) have been described, definitive diagnosis is difficult due to overlapping features with other tumors. We describe the largest series to date of superficial SFT. For inclusion, SFT had to arise in dermis or subcutis. Twenty-six cases were identified. Patients ranged from 16 to 80 years (mean, 47 y) with a marked female predominance (19 F; 7 M). Tumors involved the head (11), thigh (7), back (3), shoulder (2), upper arm (1), ankle (1), and great toe (1). Mean size was 2.9 cm (range, 1.0 to 7.0 cm). The majority (n=19) had typical histologic features (cellular SFT) with irregular fascicles of spindled cells, staghorn-like blood vessels, and variable amounts of collagen. Necrosis was evident in 3 cases (all <25%). Mitotic activity ranged from 0 to 10 mitotic figures/10 high-power fields (mean, 2 mitotic figures/10 high-power fields). Seventeen of the 18 were positive for STAT6, whereas 21/22 expressed CD34. All were low risk (23/23) by proposed criteria (Demicco and colleagues), including 2 cases with malignant histology. Three could not be risk stratified due to lack of information on tumor size. Follow-up, available on 7 cases, showed no recurrence/metastasis (mean follow-up, 100 mo; range, 2 to 241 mo). Cutaneous SFT are more common in women and most often involve the head. They are usually low risk by proposed criteria and appear to behave in an indolent manner, though larger studies are needed to confirm this. Recognition that SFT may present as a superficial mass will avoid misclassification as other CD34-positive neoplasms that frequently arise in the skin and subcutaneous tissue.
Collapse
|
4
|
Shin K, Kim TW, Lee HJ, Park SM, Jin H, Shim WH, Kim GW, Kim HS, Ko HC, Kim BS, Kim MB, You HS. A Case of Malignant Solitary Fibrous Tumor of the Skin. Ann Dermatol 2019; 31:226-228. [PMID: 33911576 PMCID: PMC7992671 DOI: 10.5021/ad.2019.31.2.226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/07/2018] [Accepted: 03/14/2018] [Indexed: 11/20/2022] Open
Affiliation(s)
- Kihyuk Shin
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Tae-Wook Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Hyun-Joo Lee
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Sung-Min Park
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Hyunju Jin
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Woo-Haing Shim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Gun-Wook Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyang-Suk You
- Department of Dermatology, Pusan National University School of Medicine, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| |
Collapse
|
5
|
Abstract
This overview of mesenchymal tumors presenting in the skin and/or subcutis in children brings together the range of neoplasms and hamartomas which are seen in this age-group. It is not surprising from the perspective of the pediatric or general surgical pathologist that vascular anomalies, including true neoplasms and vascular malformations, are the common phenotypic category. Since there is considerable morphologic overlap among these lesions, clinicopathologic correlation may be more important than for many of the other mesenchymal tumors. The skin and subcutis are the most common sites of clinical presentation for the infantile myofibroma which is the most common of fibrous mesenchymal tumors in children. Several of the other mesenchymal tumors are more common adults-like dermatofibrosarcoma protuberans, but nonetheless have an important presence in children, even as a congenital neoplasm. A lipomatous tumor in a young child should be considered as a possible manifestation of an overgrowth syndrome.
Collapse
Affiliation(s)
- Louis P Dehner
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri.,2 Dermatopathology Center and Division of Dermatology, Washington University Medical Center, St. Louis, Missouri
| | - Alejandro A Gru
- 3 Department of Pathology, University of Virginia, Charlottesville, Virginia.,4 Department of Dermatology, University of Virginia, Charlottesville, Virginia
| |
Collapse
|
6
|
Broadening the Anatomic Landscape of Sclerosing Perineurioma: A Series of 5 Cases in Nonacral Sites. Am J Dermatopathol 2016; 39:679-681. [PMID: 27845943 DOI: 10.1097/dad.0000000000000773] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sclerosing perineurioma is a rare perineurioma variant thought to occur almost exclusively in digits and palms, predominantly in young adult men. It clinically presents as a solitary slow-growing nodule, sometimes associated with prior trauma. Since 01/01/2000, our institution has received 5 cases in consultation of sclerosing perineurioma presenting in atypical locations. Four of 5 patients were women. The median age at presentation was 45 years (range, 31-62 years). Sites included dorsal tongue, anterior neck, mid upper back, forearm, and proximal anterior thigh. Complete clinical histories were not available, although lesions were reported as subcentimeter nodules with at least 1 suspected to have formed after trauma. Histologically, all lesions were circumscribed to dermal/submucosal tumors. Some extended into subcutaneous fat. The neoplasms were composed of an admixture of bland spindled to epithelioid cells with uniform, wavy, thin-to-oval nuclei forming linear cords to whorled sheets in an extensively hyalinized stroma. Mitotic activity was inconspicuous. All tumors expressed epithelial membrane antigen and were negative for S100 protein. All cases stained for CD34 were positive (3/3). This series highlights a broader clinical presentation of sclerosing perineurioma than previously recognized. Acknowledgment of this anatomic variability should provide confidence to dermatopathologists faced with similar cases.
Collapse
|
7
|
Kean CA, Moore BR, Nettles AM, Bui RP. Extrapleural Solitary Fibrous Tumor of the Foot A Case Report. J Am Podiatr Med Assoc 2015; 105:557-9. [PMID: 26667509 DOI: 10.7547/13-126.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Solitary fibrous tumors are uncommon mesenchymal neoplasms that were initially described as pleural tumors, but in recent years, numerous extrapleural sites have been reported. A solitary fibrous tumor is characterized as a circumscribed, painless mass with a patternless growth pattern, positive CD34 spindle-shaped cells, bcl-2, and dense keloidal collagen with areas of hypercellularity and hypocellularity. This case report describes a 55-year-old male veteran who presented with a rare manifestation of an extrapleural solitary fibrous tumor of the medial right hallux. Microscopic and immunohistochemical findings were consistent with the previously documented characteristics of solitary fibrous tumors. Complete surgical excision of the tumor is the treatment of choice.
Collapse
Affiliation(s)
- Charles A. Kean
- Podiatric Medicine and Surgery Program, Charlie Norwood VA Medical Center, Augusta, GA. Dr. Bui is now with Gulf Coast Veterans Healthcare System, Biloxi, MS
| | - Bridget R. Moore
- Podiatric Medicine and Surgery Program, Charlie Norwood VA Medical Center, Augusta, GA. Dr. Bui is now with Gulf Coast Veterans Healthcare System, Biloxi, MS
| | - Ashley M. Nettles
- Podiatric Medicine and Surgery Program, Charlie Norwood VA Medical Center, Augusta, GA. Dr. Bui is now with Gulf Coast Veterans Healthcare System, Biloxi, MS
| | - Richard P. Bui
- Podiatric Medicine and Surgery Program, Charlie Norwood VA Medical Center, Augusta, GA. Dr. Bui is now with Gulf Coast Veterans Healthcare System, Biloxi, MS
| |
Collapse
|
8
|
|
9
|
Affiliation(s)
- Tadashi Terada
- Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.
| |
Collapse
|
10
|
Cutaneous CD34+ Spindle Cell Neoplasms: Histopathologic Features Distinguish Spindle Cell Lipoma, Solitary Fibrous Tumor, and Dermatofibrosarcoma Protuberans. Am J Dermatopathol 2010; 32:764-8. [DOI: 10.1097/dad.0b013e3181d0c587] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
11
|
Goulão J, Furtado C, Bártolo E, Brandão FM. Solitary fibrous tumour of the skin. J Eur Acad Dermatol Venereol 2009; 23:843-4. [PMID: 19207650 DOI: 10.1111/j.1468-3083.2008.03042.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
12
|
Cutaneous Solitary Fibrous Tumor: A Report of 2 Cases and Review of the Literature. Am J Dermatopathol 2008; 30:54-8. [DOI: 10.1097/dad.0b013e31815b9bed] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
13
|
Erdag G, Qureshi HS, Patterson JW, Wick MR. Solitary fibrous tumors of the skin: a clinicopathologic study of 10 cases and review of the literature. J Cutan Pathol 2007; 34:844-50. [DOI: 10.1111/j.1600-0560.2006.00728.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
|
14
|
Yébenes M, Gilaberte M, Romaní J, Lloreta J, Pujol RM. Cranial fasciitis in an 8-year-old boy: clinical and histopathologic features. Pediatr Dermatol 2007; 24:E26-30. [PMID: 17845151 DOI: 10.1111/j.1525-1470.2007.00434.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Cranial fasciitis is an uncommon benign disorder characterized by a fibroblast-like cell proliferation, observed almost exclusively in children. Clinically, it manifests as a rapidly growing, solitary nodule in the head or neck area. Underlying bone involvement (cranial cortical erosion) is frequently detected. Histopathologic analysis allows differentiation between cranial fasciitis and fibrohistiocytic or even sarcomatous lesions observed in children. Cranial fasciitis is considered to be a reactive, non-neoplastic disorder and is usually cured by a simple excision. An increased awareness of the clinical and histopathologic characteristics of this entity seems important to establish the diagnosis, to adopt an adequate, conservative treatment and to avoid unnecessarily aggressive procedures.
Collapse
Affiliation(s)
- Mireia Yébenes
- Department of Dermatology, Hospital del Mar, IMAS, Barcelona, Spain
| | | | | | | | | |
Collapse
|
15
|
Daigeler A, Lehnhardt M, Langer S, Steinstraesser L, Steinau HU, Mentzel T, Kuhnen C. Clinicopathological findings in a case series of extrathoracic solitary fibrous tumors of soft tissues. BMC Surg 2006; 6:10. [PMID: 16824225 PMCID: PMC1523192 DOI: 10.1186/1471-2482-6-10] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2006] [Accepted: 07/06/2006] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Solitary fibrous tumors (SFT) represent a rare entity of soft tissue tumors. Previously considered being of serosal origin and solely limited to the pleural cavity the tumor has been described in other locations, most particularly the head and neck. Extrathoracic SFT in the soft tissues of the trunk and the extremities are very rare. Nine cases of this rare tumor entity are described in the course of this article with respect to clinicopathological data, follow-up and treatment results. METHODS Data were obtained from patients' records, phone calls to the patients' general practitioners, and clinical follow-up examination, including chest X-ray, abdominal ultrasound, and MRI or computed tomography. RESULTS There were 6 females and 3 males, whose age at time of diagnosis ranged from 32 to 92 years (mean: 62.2 years). The documented tumors' size was 4.5 to 10 cm (mean: 7 cm). All tumors were located in deep soft tissues, 3 of them epifascial, 2 subfascial, 4 intramuscular. Four tumors were found at the extremities, one each at the flank, in the neck, at the shoulder, in the gluteal region, and in the deep groin. Two out of 9 cases were diagnosed as atypical or malignant variant of ESFT. Complete resection was performed in all cases. Follow-up time ranged from 1 to 71 months. One of the above.mentioned patients with atypical ESFT suffered from local relapse and metastatic disease; the remaining 8 patients were free of disease. CONCLUSION ESFT usually behave as benign soft tissue tumors, although malignant variants with more aggressive local behaviour (local relapse) and metastasis may occur. The risk of local recurrence and metastasis correlates to tumor size and histological status of surgical resection margins and may reach up to 10% even in so-called "benign" tumors. Tumor specimens should be evaluated by experienced soft tissue pathologists. The treatment of choice is complete resection followed by extended follow-up surveillance.
Collapse
Affiliation(s)
- Adrien Daigeler
- Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-University-Hospital "Bergmannsheil", Ruhr-University Bochum, Germany
| | - Marcus Lehnhardt
- Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-University-Hospital "Bergmannsheil", Ruhr-University Bochum, Germany
| | - Stefan Langer
- Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-University-Hospital "Bergmannsheil", Ruhr-University Bochum, Germany
| | - Lars Steinstraesser
- Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-University-Hospital "Bergmannsheil", Ruhr-University Bochum, Germany
| | - Hans-Ulrich Steinau
- Department of Plastic Surgery, Burn Center, Hand Center, Sarcoma Reference Center, BG-University-Hospital "Bergmannsheil", Ruhr-University Bochum, Germany
| | - Thomas Mentzel
- Dermatohistopathologisches Gemeinschaftslabor, Friedrichshafen, Germany
| | - Cornelius Kuhnen
- Institute of Pathology, BG-Hospital "Bergmannsheil", Ruhr-University, Bochum, Germany
| |
Collapse
|
16
|
Matsushita S, Uemura T, Sugihara H, Hashimoto H, Tanabe T, Saito T, Watanabe H. A solitary fibrous tumor arising in the perioral region. J Dermatol 2006; 32:1041-3. [PMID: 16471474 DOI: 10.1111/j.1346-8138.2005.tb00898.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
17
|
Abstract
BACKGROUND Trichodiscomas are rare hamartomas of the dermal portion of the hair disc, a specialized component of the perifollicular mesenchyme. They are usually found as asymptomatic multiple skin-colored papules on the face and extremities and may have an autosomal dominant inheritance pattern. However, a solitary variant has been described. CASE REPORT A 78-year-old woman presented with a single, non-pigmented, firm papule on the left tip of the nose, measuring 3.5 mm in diameter. RESULTS The histological examination revealed the previously described features of a trichodiscoma. The immunohistochemical analysis showed strong immunoreactivity for CD34 in the spindle cell component. Spindle cells were negative for S-100, HMB-45, Melan-A, EMA, neurofilament, desmin, and Factor XIIIa by immunohistochemistry. CONCLUSIONS We report strong reactivity for CD34 in the spindle cell component of a trichodiscoma. We suggest that this lesion be considered in the differential diagnosis of any CD34+ dermal spindle cell proliferation, in which an adjacent epithelial component cannot be entirely excluded.
Collapse
Affiliation(s)
- Molly Chartier
- Department of Dermatology, University of Connecticut Health Center, Dowling South, 263 Farmington Avenue, Farmington, CT 06030, USA
| | | | | | | | | | | |
Collapse
|
18
|
Abstract
We describe the case of a 74-year-old man with a mediastinal tumor composed predominantly of epithelioid cells exhibiting histopathologic and immunohistochemical features intermediate between those of a solitary fibrous tumor and those of a cellular adenomatoid tumor. We discuss the differential diagnosis and possible histogenesis of this unusual neoplasm, and we propose the term epithelioid solitary fibrous tumor for this entity.
Collapse
Affiliation(s)
- Alberto M Marchevsky
- Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, Calif 90048, USA.
| | | | | |
Collapse
|