Collision of Atypical Fibroxanthoma and Acantholytic Squamous Cell Carcinoma In Situ

Hyatt, Ann-Marie; Mutasim, Diya F.; Spicknall, Kerith E.

doi:10.1097/dad.0b013e31822e63c8

Cited by 7 publications

(6 citation statements)

References 10 publications

(4 reference statements)

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“…The speculation that AFX may represent EMT of squamous cell carcinoma is based on some clinical and molecular observations. Clinically, collision of AFX and acantholytic squamous cell carcinoma in situ has been reported [94]. AFX, lentigo maligna melanoma and squamous cell carcinoma arising at the site of a thermal burn treated with skin grafts have been observed [95][96][97].…”

Section: A Speculative View About Afx and Epithelial-mesenchymal Transimentioning

confidence: 99%

Atypical fibroxanthoma: new insights

Hussein

2014

Expert Review of Anticancer Therapy

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Atypical fibroxanthoma (AFX) is an ultraviolet radiation-associated dermal neoplasm. To address the clinicopathologic and molecular features of this particular neoplasm. The author conducted a literature review using PubMed searching for articles relating to AFX. AFX usually appears as a rapidly growing nodular or nodulo-ulcerative lesion. It occurs on sun-exposed skin of elderly peoples. AFX may be composed predominantly of pleomorphic, spindle, epithelioid cells, or admixture of these cells. The differential diagnosis of AFX includes pleomorphic dermal sarcoma, squamous cell carcinoma, malignant melanoma and leiomyosarcoma. Several observations favor a mesenchymal origin for AFX. These reviews address the clinicopathologic features, molecular pathology, prognosis and treatment of this neoplasm.

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Section: A Speculative View About Afx and Epithelial-mesenchymal Transimentioning

confidence: 99%

Atypical fibroxanthoma: new insights

Hussein

2014

Expert Review of Anticancer Therapy

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“…The distinct transition in both the morphology and immunophenotype between the components of melanoma in our case example prompted some consideration of this possibility. Collisions of AFX and melanoma, AFX and melanocytic nevi, and AFX and squamous cell carcinoma are rare but nonetheless well‐documented . In our case, the overlap in SNP copy number changes and oncogenic mutations suggested a common origin for both the differentiated and undifferentiated sarcomatoid components of this melanoma.…”

Section: Discussionmentioning

confidence: 56%

CD10 and p63 expression in a sarcomatoid undifferentiated melanoma: A cautionary (and molecularly annotated) tale

et al. 2020

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Undifferentiated melanoma should be considered in the differential diagnosis of sarcomatoid cutaneous malignancies to ensure that patients receive the correct treatment. Dermatopathologists should recognize the pitfalls of relying too heavily on immunohistochemistry to establish this diagnosis and consider ancillary tests, including single-nucleotide polymorphism (SNP) copy number arrays and targeted next-generation sequencing (NGS), when a definitive diagnosis cannot be rendered on a primary or metastatic tumor. This technology can also help to exclude a collision of melanoma and sarcoma when both differentiated and undifferentiated components are juxtaposed. We describe an exceedingly rare, illustrative example of undifferentiated sarcomatoid melanoma presenting as a pedunculated nodule. The clinical context and presence of a small differentiated component helped to establish the diagnosis; however, the transition from differentiated to undifferentiated melanoma was accompanied by an abrupt loss of S100, Sox10, MITF, MelanA, and HMB45 with gain of CD10 and p63 staining. SNP copy number array and NGS revealed shared chromosomal copy number changes and overlapping mutations with additional aberrances detected exclusively in the sarcomatoid component, thereby excluding a collision tumor and confirming our putative impression of melanoma with progression to an undifferentiated sarcomatoid phenotype. K E Y W O R D Satypical fibroxanthoma, high-risk skin cancer, immunohistochemistry, melanoma, molecular pathology, pleomorphic dermal sarcoma

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“…1,2 SCCis can also be seen adjacent to AFX, but only in infrequent instances ($5% of AFX). 7,8 In addition, positive SMA expression could be misinterpreted as the tumor having a mesenchymal origin, but aberrant IHC expression of mesenchymal markers in spindle cell SCC such as SMA and vimentin has been reported. 9,10 Therefore, immunohistochemistry is key to confirming an epithelial origin with diffuse positive staining for both low and high molecular weight cytokeratins (CK5/6, CK AE1/AE3, CK8/18, etc.)…”

Section: Discussionmentioning

confidence: 99%

Cutaneous myxoid spindle cell squamous cell carcinoma

Brooks,

Talty,

Marion

et al. 2024

J Cutan Pathol

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Collision of Atypical Fibroxanthoma and Acantholytic Squamous Cell Carcinoma In Situ

Cited by 7 publications

References 10 publications

Atypical fibroxanthoma: new insights

Atypical fibroxanthoma: new insights

CD10 and p63 expression in a sarcomatoid undifferentiated melanoma: A cautionary (and molecularly annotated) tale

Cutaneous myxoid spindle cell squamous cell carcinoma

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