Clear Cell Atypical Fibroxantoma: A Rare Variant of Atypical Fibroxanthoma and Review of the Literature

Bedir, Recep; Agirbas, Sule; Şehitoğlu, İbrahim; Yurdakul, Cüneyt; Elmas, Ömer Faruk

doi:10.7860/jcdr/2014/8798.4466

Cited by 7 publications

(24 citation statements)

References 11 publications

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“…27 Morphological features were the ones usually observed in clear cell AFX and the immunohistochemical study showed expression of vimentin, CD68, and CD10 and negativity for S100 protein, melan A, HMB45, MSA, and CK. In a recently reported case, the lesion was located on the shoulder of a 74-year-old male patient.…”

Section: Discussionmentioning

confidence: 69%

“…Only 12 examples of clear cell AFX have been reported to date, 15,[20][21][22][23][24][25][26][27] all of them as case reports with the exception of a small series of 3 cases. 22 We present 6 new cases of this variant, representing 5% of the AFX from our files.…”

Section: Discussionmentioning

confidence: 99%

“…AFX usually expresses CD10 and CD99, and a high number of cases also stain for smooth muscle actin (SMA) and CD68, 3,4 but unfortunately these staining results lack specificity. 15,[20][21][22][23][24][25][26][27] We hereby report the clinicopathologic features of 6 cases of clear cell AFX from our files, and review the literature, with special emphasis on the differential diagnosis. 10,11 Several morphological variants have been described, including the monomorphic spindle cell, 12 keloidal, 13 granular cell, 14 clear cell, 15 osteoclast-like giant cell, 16 pigmented hemosiderotic, 17 pseudoangiomatous, 18 and myxoid variants.…”

Section: Introductionmentioning

confidence: 99%

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Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis

Tardío

Pinedo

Aramburu

et al. 2016

The American Journal of Dermatopathology

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Atypical fibroxanthoma (AFX) is an uncommon dermal-based neoplasm arising on the sun-damaged skin of elderly people. Clear cell AFX is a rare variant with only 12 cases reported until the present date, all of them as case reports, except for 1 small series of 3 cases. The authors report 6 new cases and review the literature with special emphasis on the differential diagnosis. The clear cell variant represents 5% of AFX from their files. Histopathologically, it consists of sheets of epithelioid, pleomorphic cells, intermixed with a varying number of giant multinucleated and spindle cells, the latter arranged in a fascicular pattern. All cell types predominantly exhibit a clear, microvacuolated cytoplasm with well-demarcated cell borders. The clinical and immunohistochemical features of this variant are similar to those of the classic type. Clear cell AFX must be differentiated from other cutaneous clear cell neoplasms, some of them with an aggressive clinical behavior, including clear cell melanoma, primary cutaneous and metastatic clear cell carcinomas, clear cell sarcoma, pleomorphic liposarcoma, tumor of perivascular epithelioid cells, and distinctive dermal clear cell mesenchymal neoplasm. The clinical presentation and immunohistochemical profile play a key role in the differential diagnosis.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis

Tardío

Pinedo

Aramburu

et al. 2016

The American Journal of Dermatopathology

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“…The lesions can range from 1 to more than 6 cm in diameter, but are typically 1 to 2 cm . Risk factors for AFX include a history of high ultraviolet exposure, radiation exposure, previous trauma, receiving a transplant or chronic immunosuppression . Ultraviolet signature mutations in the p53 gene and pyrimidine dimers seen in affected cells support the role of sun‐mediated damage in the lesion's pathogenesis .…”

Section: Discussionmentioning

confidence: 97%

“…Thus, despite the few number of CCAFX cases reported, there is a suggested prevalence of 1–2% of AFX cases . In addition to the Touton‐like appearance of the atypical multinucleated cells and presence of numerous mitotic figures characteristic of AFX, the histology of CCAFX includes numerous clear cells with vacuolated and foamy cytoplasm . The vacuolization may result from lipid accumulation within the cytoplasm.…”

Section: Discussionmentioning

confidence: 99%

Clear cell atypical fibroxanthoma: a case report and review of the literature

2016

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Atypical fibroxanthoma (AFX) is a group of cutaneous tumors characterized by a population of fusiform, epithelioid and pleomorphic cells. Clinically, AFX is commonly found on the head and neck of older adults as a solitary ulcerated nodule. Clear cell atypical fibroxanthoma is a very rare variant of AFX, with only 13 cases reported to date. The differential diagnoses often include dermal neoplasms composed of clear cells, such as squamous cell carcinoma, basal cell carcinoma, metastatic renal cell carcinoma and balloon cell malignant melanoma. These diagnoses can be ruled out by the typical immunohistochemical profile of clear cell AFX, which is negative for specific epithelial and melanocytic markers. Herein, we describe a rare and unusual case of clear cell AFX arising on the ear of a relatively young adult patient. Histologically, the dermis was completely replaced by an atypical population of vacuolated cells with numerous atypical mitoses. Immunohistochemical stains were negative forpancytokeratin, CK5/6, CK7, and p63 S100 and Melan-A stains. CD10 and CD68 stains were positive, making the findings consistent with the diagnosis of clear cell atypical fibroxanthoma.

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Pleomorphic dermal sarcoma with osteosarcoma-like and chondrosarcoma-like elements

2016

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Clear Cell Atypical Fibroxantoma: A Rare Variant of Atypical Fibroxanthoma and Review of the Literature

Cited by 7 publications

References 11 publications

Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis

Clear Cell Atypical Fibroxanthoma: Clinicopathological Study of 6 Cases and Review of the Literature With Special Emphasis on the Differential Diagnosis

Clear cell atypical fibroxanthoma: a case report and review of the literature

Pleomorphic dermal sarcoma with osteosarcoma-like and chondrosarcoma-like elements

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