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Suzuki‐Ueno M, Fujikawa Y, Hamaoka D, Umemura K, Ohnishi T. A collision tumor of basal cell carcinoma and atypical fibroxanthoma: A case report. Clin Case Rep 2024; 12:e9250. [PMID: 39171331 PMCID: PMC11335460 DOI: 10.1002/ccr3.9250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/28/2024] [Accepted: 07/21/2024] [Indexed: 08/23/2024] Open
Abstract
An 83-year-old man presented an elevated skin lesion in the left temporal area. The resected specimen was identified between a basal cell carcinoma and an atypical fibroxanthoma. A final diagnosis of basal cell carcinoma and atypical fibroxanthoma was made. This study reports a rare case of a cutaneous collision.
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Affiliation(s)
| | | | - Dai Hamaoka
- Department of DermatologyNishiwaki Municipal HospitalNishiwakiJapan
| | - Kaoru Umemura
- Department of DermatologyNishiwaki Municipal HospitalNishiwakiJapan
| | - Takamasa Ohnishi
- Department of Diagnostic PathologyNishiwaki Municipal HospitalNishiwakiJapan
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Dhaliwal D, Sayyadioskoie S, Siatecka H, Hunt C, Diwan AH. A Tale of Two Tumors: A Collision Tumor of Atypical Fibroxanthoma and Basal Cell Carcinoma. Am J Dermatopathol 2024; 46:309-311. [PMID: 38574065 DOI: 10.1097/dad.0000000000002694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
ABSTRACT A collision tumor is an infrequent phenomenon characterized by the presence of 2 histologically distinct tumor types (either benign or malignant) occurring within the same specific anatomical site. We describe a rare case of co-occurrence of basal cell carcinoma and atypical fibroxanthoma presenting as a single lesion on the scalp in a 76-year-old man. The lesion was clinically suspicious for basal cell carcinoma and biopsied. Histologic examination showed 2 distinct tumors, one with basaloid cells and the other one with pleomorphic spindle cells colliding and growing together. Immunohistochemical stains were crucial in establishing the diagnosis. This presentation is exceedingly rare and requires additional evaluation for diagnosis.
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Affiliation(s)
- Dilshad Dhaliwal
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| | | | - Hanna Siatecka
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| | | | - A Hafeez Diwan
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
- Department of Dermatology, Baylor College of Medicine, Houston, TX; and
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Perandones González H, Miguel Valladares Narganes L, Asunción González Morán M, Ángel Rodríguez Prieto M. Collision of basal cell carcinoma and atypical fibroxanthoma. Indian J Dermatol Venereol Leprol 2023; 0:1-3. [PMID: 37436024 DOI: 10.25259/ijdvl_220_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/11/2023] [Indexed: 07/13/2023]
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Dekanić A, Velepič M, Gobić MB, Hadžisejdić I, Jonjić N. Undifferentiated pleomorphic sarcoma in oropharyngeal mucosa of patients with multiple basal cell carcinomas. Rare Tumors 2021; 13:20363613211026483. [PMID: 34276919 PMCID: PMC8256239 DOI: 10.1177/20363613211026483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 06/01/2021] [Indexed: 11/15/2022] Open
Abstract
Malignant mesenchymal tumors of oropharyngeal mucosa are rare. Those with fibroblastic and histiocytic differentiation in the skin are called atypical fibroxanthoma (AFX) and in the soft tissue undifferentiated pleomorphic sarcoma (UPS). Here we present a case of an older patient with a history of multiple basal cell carcinomas and recently with a rapidly growing polypoid lesion in the mucosa of posterior oropharyngeal wall with AFX/UPS morphology. The differential diagnosis, histological pitfalls of this poorly characterized mesenchymal lesions, and the challenges associated with treatment are discussed.
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Affiliation(s)
- Andrea Dekanić
- University of Rijeka Faculty of Medicine,
Rijeka, Croatia
| | - Marko Velepič
- Clinic for Otorhinolaryngology, Clinical
Hospital Center Rijeka, Rijeka, Croatia
| | | | - Ita Hadžisejdić
- Department of Pathology and Cytology,
Clinical Hospital Center Rijeka, Rijeka, Croatia
| | - Nives Jonjić
- Department of Pathology and Cytology,
Clinical Hospital Center Rijeka, Rijeka, Croatia
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Cohen PR, Calame A. Multiple Skin Neoplasms at One Site (MUSK IN A NEST): A Comprehensive Review of Basal Cell Carcinoma and Benign or Malignant "Collision" Tumors at the Same Cutaneous Location. Clin Cosmet Investig Dermatol 2020; 13:731-741. [PMID: 33061513 PMCID: PMC7532883 DOI: 10.2147/ccid.s259324] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022]
Abstract
Multiple skin neoplasms at one site (MUSK IN A NEST), initially referred to as a collision tumor, describes the occurrence of two or more benign or malignant neoplasms that are adjacent or intermingled at the same cutaneous site. A mononeoplastic cutaneous tumor refers to a single tumor at any cutaneous site. Two, three, four, five, and six tumors at the same site are described as dineoplastic, trineoplastic, tetraneoplastic, pentaneoplastic, and hexaneoplastic cutaneous tumors, respectively; the prefixes are based on the numerical multiplier used by the International Union of Pure and Applied Chemistry (IUPAC). MUSK IN A NEST can be classified based upon their mechanism of pathogenesis-either being composed of mixed clones of cells (clonalium, which has three subtypes: collision, colonization, and combination) or the same clone of cells that has undergone clonal evolution (clonalidem, which has one subtype: biphenotypic). Basal cell carcinoma (BCC)-associated MUSK IN A NEST can be observed with either benign tumors, malignant tumors, or both. Nevi and seborrheic keratoses are the most common benign tumors associated with BCC; melanoma in situ and invasive melanoma are the most commonly reported malignant tumors associated with BCC. The definitive etiology of BCC-associated MUSK IN A NEST remains to be established-whether the development of the BCC at that site occurs as a direct or indirect consequence of the coexisting neoplasm or whether the occurrence of the BCC and the other neoplasm is merely the result of a coincidental juxtaposition of the tumors.
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Bulte CA, Hoegler KM, Khachemoune A. Collision tumors: A review of their types, pathogenesis, and diagnostic challenges. Dermatol Ther 2020; 33:e14236. [PMID: 32852089 DOI: 10.1111/dth.14236] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 08/09/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022]
Abstract
A collision tumor is a neoplastic lesion comprised of two or more distinct cell populations that maintain distinct borders. Collision tumors, which are rare but well documented, can be composed of two benign tumors, a benign and malignant tumor, and two malignant tumors. Although case reports and reviews on specific types of collision tumors exist, a cohesive source discussing these tumors is lacking. We critically reviewed the literature by analyzing case reports and retrospective studies in order to evaluate the following regarding collision tumors: definitions, types, pathogenesis, diagnosis, and management. Reports of these tumors are infrequent but not insignificant, and accurate classification and diagnosis will lead to better patient outcomes.
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Affiliation(s)
- Camille A Bulte
- Department of Dermatology, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Karl M Hoegler
- Department of Dermatology, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Amor Khachemoune
- Brooklyn Campus of the VA NY Harbor Healthcare System, Brooklyn, New York, USA.,Department of Dermatology, SUNY Downstate, Brooklyn, New York, USA
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Bitel A, Schönlebe J, Krönert C, Wollina U. Atypical fibroxanthoma: An analysis of 105 tumors. Dermatol Ther 2020; 33:e13962. [PMID: 32618393 DOI: 10.1111/dth.13962] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 12/13/2022]
Abstract
Atypical fibroxanthoma (AFX) is a rare, low-grade dermal sarcoma. We analyzed our files from January 2001 to January 2020 for AFX. Clinical parameters, histopathology, treatment and outcome have been investigated. We identified 87 patients (mean age of 80.0 ± 8.4 years) with 105 confirmed tumors. Of these patients 86.2% were males. The most common clinical presentation was nodular (93.3%). The majority of AFX was located on the head with a mean tumor diameter of 15.0 mm ± 3.5 mm. All tumors showed a dermal localization, in 46.4% with a focal infiltration of the deeper layers. Second skin cancer was reported in 62.1% of patients. Collision tumors were seen in six patients. Treatment was surgical with three-dimensional margin control. Relapses were noted in 11.4% of tumors with a mean delay of 11.7 ± 17.3 months. Focally deeper infiltration of AFX was a risk factor (P = .014). None of the purely dermal AFX relapsed. No metastasis was observed. AFX is a rare mesenchymal tumor of elderly patients. Treatment of choice is the complete surgical excision. Due to the high rate of other skin malignancies among patients with AFX, a regular follow-up is recommended.
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Affiliation(s)
- Alena Bitel
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
| | - Jacqueline Schönlebe
- Institute of Pathology "Georg Schmorl", Städtisches Klinikum Dresden, Dresden, Germany
| | - Claudia Krönert
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
| | - Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Dresden, Germany
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Leecy T, Ardakani NM, Harvey NT, Wood BA. Pilomatrical carcinosarcoma: report of a case with comparative genomic hybridisation analysis. Pathology 2018; 50:571-573. [PMID: 29954591 DOI: 10.1016/j.pathol.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/16/2018] [Accepted: 02/22/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Tamazin Leecy
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia.
| | | | - Nathan T Harvey
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
| | - Benjamin A Wood
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
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Commentary to the Article "A Rare Collision in Dermatopathology: Basal Cell Carcinoma and Atypical Fibroxanthoma". Am J Dermatopathol 2017; 40:75-76. [PMID: 28169868 DOI: 10.1097/dad.0000000000000835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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