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Pietramala S, Tulli A, Merendi G, Fulchignoni C, Quirino M, Di Napoli N, Tagliaferri L, Pagliei A. Spindle-cell myoepithelioma: A rare case in a finger of a 15-year-old boy. HAND SURGERY & REHABILITATION 2023; 42:549-552. [PMID: 37714516 DOI: 10.1016/j.hansur.2023.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 08/22/2023] [Accepted: 09/05/2023] [Indexed: 09/17/2023]
Abstract
Cutaneous myoepithelioma is a rare neoplasm of the skin that has become more widely recognized in recent years despite significant diagnostic pitfalls. It is a benign neoplasm with a high recurrence rate if not excised radically, and must be distinguished from its malignant counterpart. Few cases have been described so far and, to our knowledge, no cases in the finger of a child exist in the literature. We report the case of a 15 year-old boy affected by a rare form of locally aggressive spindle-cell myoepithelioma, and suggest a new multidisciplinary approach combining surgical excision and custom brachytherapy.
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Affiliation(s)
- Silvia Pietramala
- Hand Surgery and Orthopaedics Unit, Department of Orthopaedics and Traumatology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Antonio Tulli
- Hand Surgery and Orthopaedics Unit, Department of Orthopaedics and Traumatology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianfranco Merendi
- Hand Surgery and Orthopaedics Unit, Department of Orthopaedics and Traumatology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Camillo Fulchignoni
- Hand Surgery and Orthopaedics Unit, Department of Orthopaedics and Traumatology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Michela Quirino
- Clinical Oncology Unit, Department of Internal Medicine, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Nicola Di Napoli
- Department of Radiation Oncology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luca Tagliaferri
- Department of Radiation Oncology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Antonio Pagliei
- Hand Surgery and Orthopaedics Unit, Department of Orthopaedics and Traumatology, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Sivasaththivel M, Howard MD, Yazdabadi A. Acral fibromyxoma: a rare plantar nodule. BMJ Case Rep 2022; 15:e247565. [PMID: 35750432 PMCID: PMC9234790 DOI: 10.1136/bcr-2021-247565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 11/04/2022] Open
Abstract
Acral fibromyxomas are benign tumours ranging in size between 0.6 and 5 cm, commonly found around the nailbed. The often asymptomatic presentation of acral fibromyxomas means that there is often a delay in their diagnosis and subsequent treatment. The objective of this paper is to present the unique case of a fibromyxoma present in the acral region, as well as a review of the literature.
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Affiliation(s)
| | | | - Anousha Yazdabadi
- Medical Education, University of Melbourne, Parkville, Melbourne, Australia
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Takeda M, Sano Y, Shigekawa S, Kitazawa R, Sugimoto R, Izutani H. Use of uniportal video-assisted thoracic surgery combined with a posterior approach to resect a dumbbell-shaped mediastinal granular cell tumor: A case report. Int J Surg Case Rep 2021; 88:106460. [PMID: 34649074 PMCID: PMC8517829 DOI: 10.1016/j.ijscr.2021.106460] [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: 08/09/2021] [Revised: 09/28/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction A dumbbell-shaped mediastinal granular cell tumor has never been reported, and there have been no reports of dumbbell-shaped tumors resected with a combination of uniportal video-assisted thoracic surgery and the posterior approach. Presentation of case An 18-year-old woman was diagnosed with a mediastinal dumbbell-shaped granular cell tumor by computed tomography. Complete resection was achieved via a posterior approach combined with the uniportal video-assisted thoracic surgery. First, a T3 left hemilaminectomy was performed in the prone position and the tumor located inside the intervertebral foramen was removed as far as possible. Next, the patient was repositioned to the right lateral decubitus position, a 2.5-cm skin incision was made on the 4th intercostal posterior axillary line, and resection of the residual tumor was performed. Pathological diagnosis of the resected tumor revealed a benign granular cell tumor. The patient recovered post-surgery and no tumor was reported in the 4-month follow-up magnetic resonance imaging. Discussion This is the first reported case of a mediastinal dumbbell-shaped granular cell tumor and its successful resection using a combined posterior and uniportal video-assisted thoracic surgery approach. Conclusion This is a potentially safe and effective procedure for mediastinal granular cell tumors, with outstanding cosmetic advantages. Our case presented with a rare mediastinal dumbbell-shaped granular cell tumor. The tumor was resected using a combined posterior and uniportal VATS approach. This is a safe and effective procedure for mediastinal dumbbell-shaped tumors.
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Affiliation(s)
- Masashi Takeda
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
| | - Yoshifumi Sano
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan.
| | - Seiji Shigekawa
- Department of Neurosurgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
| | - Riko Kitazawa
- Department of Molecular Pathology, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
| | - Ryujiro Sugimoto
- Department of Thoracic Surgery, Kure Kyosai Hospital, 2-3-28 Nishi-chuou, Kure City 737-8505, Japan
| | - Hironori Izutani
- Department of Cardiovascular and Thoracic Surgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon City 791-0295, Japan
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Cutaneous Myoepithelioma: An Unusual Tumor in the Hand. Case Rep Pathol 2020; 2020:3747013. [PMID: 32607268 PMCID: PMC7313169 DOI: 10.1155/2020/3747013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 05/01/2020] [Indexed: 11/18/2022] Open
Abstract
Cutaneous myoepithelioma (CM) is a rare tumor among the primary skin neoplasms. We present the case of a patient with a diagnosis of CM in the right hypothenar region. Histological study showed a proliferation of myoepithelial cells with a solid, reticular growth pattern in a chondromyxoid stroma. The tumor cells were positive for CK AE, S-100, EMA, and p63.
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Pérez-Pérez M, Manzotti C, Merchante-Ruíz Mateos M, González-Cámpora R, Ríos-Martín JJ. Myxoinflammatory fibroblastic sarcoma: A rare case affecting only the dermis. J Cutan Pathol 2020; 47:414-415. [PMID: 31876032 DOI: 10.1111/cup.13638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 12/05/2019] [Accepted: 12/19/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Manuel Pérez-Pérez
- Department of Pathology, Universitary Hospital Virgen Macarena, Seville, Spain
| | - Carolina Manzotti
- Department of Pathology, Universitary Hospital Virgen Macarena, Seville, Spain
| | | | | | - Juan J Ríos-Martín
- Department of Pathology, Universitary Hospital Virgen Macarena, Seville, Spain
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Kanemaru H, Honda N, Kubo Y, Nishihara H, Onuma T, Sakai K, Fukushima S, Inoue Y, Honda Y, Ihn H. Case of cutaneous myoepithelioma managed with surgical resection without recurrence for 4 years. J Dermatol 2019; 46:e206-e208. [PMID: 30672605 DOI: 10.1111/1346-8138.14769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Hisashi Kanemaru
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Noritoshi Honda
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yosuke Kubo
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Haruna Nishihara
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takehiro Onuma
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Keisuke Sakai
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Satoshi Fukushima
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yuji Inoue
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Yumi Honda
- Department of Diagnostic Pathology, Kumamoto University Hospital, Kumamoto, Japan
| | - Hironobu Ihn
- Department of Dermatology and Plastic Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
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Abstract
Superficial acral fibromyxoma (SAFM) is a rare soft tissue tumor that frequently involves the periungual and subungual regions of acral surfaces. Macroscopically, it appears as a flesh-colored dome-shaped solitary mass; microscopically, it consists of a moderately cellular proliferation of spindle-shaped fibroblast-like cells embedded in a myxocollagenous stroma and arranged in a loose storiform and focally fascicular pattern. The tumor cells are immunoreactive for CD34, epithelial membrane antigen, CD99, and CD10. In this study, we describe a case of SAFM on the fourth toe with predominantly myxoid stroma. Our case, in contrast of those reported in the literature, showed an unusual location for the myxoid variant. SAFM is often not recognized; it may resemble some benign and malignant mesenchymal neoplasm. The gold standard treatment is surgery. The tumor was completely excised, and no recurrence was evident at 1-year follow-up. Awareness of this entity facilitates its diagnosis and management, avoiding unwarranted concerns and additional procedures for the patient.
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Shao HT, Ko MJ, Wen SY. A rare case of myxoinflammatory fibroblastic sarcoma with increased overlying hairs. DERMATOL SIN 2015. [DOI: 10.1016/j.dsi.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lee JH, Huang HY, Lan J, Hwang CC, Liu CY. Cutaneous syncytial myoepithelioma: A case report with emphasis on the differential diagnosis of problematic dermal tumors. Oncol Lett 2015; 9:2275-2277. [PMID: 26137055 DOI: 10.3892/ol.2015.3055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Accepted: 02/24/2015] [Indexed: 11/05/2022] Open
Abstract
Cutaneous myoepithelioma is a peculiar and recently recognized neoplasm exhibiting purely myoepithelial differentiation. These lesions affect different areas of the body, and are characterized by heterogenous morphological and immunophenotypical features. The majority of cutaneous myoepitheliomas behave in a benign fashion, however, the risk for local recurrence is higher with incomplete resection. A relatively newly described variant of myoepithelioma exhibits syncytial cytological features. The current study reports a case of cutaneous syncytial myoepithelioma presenting as a painless and papular skin lesion. The presence of the Ewing sarcoma RNA-binding protein 1 gene rearrangement in the present case supported the diagnosis of a myoepithelial tumor. The patient subsequently underwent local excision of the tumor and was followed up twice in the year after surgery. At the time of writing, the patient was alive and no recurrences had been identified. Furthermore, the current study discusses how this myoepithelial neoplasm may be distinguished from other problematic spindle or epithelioid cell tumors, particularly superficial dermal lesions.
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Affiliation(s)
- Jun-Hsiung Lee
- Department of Pathology, Sijhih Cathay General Hospital, Sijhih, New Taipei City, Taiwan, R.O.C
| | - Hsuan-Ying Huang
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, R.O.C
| | - Jui Lan
- Department of Pathology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, R.O.C
| | - Cheng-Cheng Hwang
- Department of Pathology, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C
| | - Chih-Yi Liu
- Department of Pathology, Sijhih Cathay General Hospital, Sijhih, New Taipei City, Taiwan, R.O.C. ; College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
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Weiss VL, Antonescu CR, Alaggio R, Cates JM, Gaskin D, Stefanovici C, Coffin CM. Myxoinflammatory fibroblastic sarcoma in children and adolescents: clinicopathologic aspects of a rare neoplasm. Pediatr Dev Pathol 2013; 16:425-31. [PMID: 23919754 DOI: 10.2350/13-06-1353-cr.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Myxoinflammatory fibroblastic sarcoma (MIFS), originally described as a low-grade malignant soft-tissue tumor in adults, has recently been reported in children and in non-acral sites. This report describes the clinicopathologic features of a series of 5 MIFS in children and adolescents (3 males, 2 females), ranging in age from 5 to 17 years (mean, 13 years). These tumors presented as small, superficial, slowly growing soft-tissues masses of the scalp, neck, middle finger, forearm, and thigh. Histologically, the tumors were composed of spindled and plump polygonal cells with prominent nuclear pleomorphism, nuclear pseudoinclusions; large eosinophilic nucleoli; myxoid foci intermingled with spindled foci; and an accompanying inflammatory infiltrate of lymphocytes, plasma cells, and variable neutrophils. Immunohistochemical analysis revealed variable reactivity for CD34 and smooth muscle actin in the tumor cells. Genetic analysis in 3 cases showed no rearrangements of TGFBR3 or MGEA5. Follow up in 4 cases revealed no recurrence or metastasis. These 5 cases of childhood and adolescent MIFS demonstrate an expanded age range and topographic distribution and a favorable outcome. The differential diagnosis and importance of recognizing this rare neoplasm in young patients are discussed.
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Affiliation(s)
- Vivian L Weiss
- 1 Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, USA
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Tivoli YA, Thomas JA, Chen AF, Weiss ET. Acral myxoinflammatory fibroblastic sarcoma successfully treated using Mohs micrographic surgery. Dermatol Surg 2013; 39:1709-11. [PMID: 24118192 DOI: 10.1111/dsu.12308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yvette A Tivoli
- Nova Southeastern University/Broward General Medical Center, Fort Lauderdale, Florida
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12
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Abstract
Cutaneous myoepithelioma is a very rare, benign, subcutaneous and dermal tumor. It usually presents as a slow-growing and painless mass on the extremities. We report a case of cutaneous myoepithelioma that was located on the foot. A 68-year old woman presented with a slowly growing pain-free mass on the right third toe measuring 0.8 × 0.7 × 0.4 cm(3). We performed an elliptical excision, with histological and immunohistochemical analysis. The lesion showed dermis with cords of cytologically uniform ovoid cells with moderate amount of pale cytoplasm. No pleomorphism, mitotic activity, or necrosis was visualized. The tumor cells were positive for S-100 protein, epithelial membrane antigen and negative for smooth-muscle actin. From these findings, the tumor was diagnosed as a cutaneous myoepithelioma extending to the deep resection margin. To our knowledge, there are only 2 documented cases in the literature in English, and none have been reported in the foot and ankle literature.
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Affiliation(s)
- Brian T Dix
- Department of Foot and Ankle Surgery, Western Pennsylvania Hospital, Pittsburgh, PA 15224, USA
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Willard KJ, Cappel MA, Kozin SH, Abzug JM. Benign subungual tumors. J Hand Surg Am 2012; 37:1276-86; quiz 1286. [PMID: 22560606 DOI: 10.1016/j.jhsa.2012.04.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 04/02/2012] [Indexed: 02/02/2023]
Abstract
A variety of benign and malignant processes may affect the subungual region; however, most are relatively rare lesions. We present a review of the current literature regarding benign tumors affecting the subungual region.
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Affiliation(s)
- Katherine J Willard
- Department of Orthopaedics, University of Maryland School of Medicine, Timonium, MD 21093, USA
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