Superficial acral fibromyxoma: A clinicopathologic and immunohistochemical analysis of 37 cases of a distinctive soft tissue tumor with a predilection for the fingers and toes

Fetsch, John F.; Laskin, William B.; Miettinen, Markku

doi:10.1053/hupa.2001.25903

Cited by 275 publications

(414 citation statements)

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“…19 In Fetchs' original study, of the 21 (of 37) cases that had follow-up, only one recurred, two persisted or progressed after local excision, and none metastasized. 19 Dermatofibrosarcoma protuberans on the other hand is locally aggressive with a very real potential for local recurrence if incompletely excised. 13 Differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans, especially its myxoid variant, is not a diagnostic dilemma if the biopsy is deep where the storiform pattern and infiltrative architecture pathognomonic of dermatofibrosarcoma protuberans are recognized.…”

Section: Discussionmentioning

confidence: 99%

“…Superficial acral fibromyxoma is a relatively uncommon, distinctive entity with a predilection for the fingers and toes of adults. 19 Unlike dermatofibrosarcoma protuberans, superficial acral fibromyxoma follows a benign biologic course. 19 In Fetchs' original study, of the 21 (of 37) cases that had follow-up, only one recurred, two persisted or progressed after local excision, and none metastasized.…”

Section: Discussionmentioning

confidence: 99%

“…19 Unlike dermatofibrosarcoma protuberans, superficial acral fibromyxoma follows a benign biologic course. 19 In Fetchs' original study, of the 21 (of 37) cases that had follow-up, only one recurred, two persisted or progressed after local excision, and none metastasized. 19 Dermatofibrosarcoma protuberans on the other hand is locally aggressive with a very real potential for local recurrence if incompletely excised.…”

Section: Discussionmentioning

confidence: 99%

“…However, the distinction can be difficult, if not impossible in a superficial biopsy, given the following; both may occur at the same site (dermatofibrosarcoma protuberans has, albeit rarely, been reported on acral skin in approximately 3% of cases). 12,19 Both can have a myxoid histologic appearance and more importantly both express CD34. One of the cases of superficial acral fibromyxoma in the current study was indeed misdiagnosed as a myxoid dermatofibrosarcoma protuberans based on the stroma and CD34 positivity (Figure 2c and d).…”

Section: Discussionmentioning

confidence: 99%

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Apolipoprotein D in CD34-positive and CD34-negative cutaneous neoplasms: a useful marker in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans

et al. 2008

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More recent techniques to characterize the genetic profile of soft-tissue tumors include the use of gene arrays. Using this technique, Apolipoprotein D (Apo D), a 33-kDa glycoprotein component of high-density lipoprotein, has been found to be highly expressed in dermatofibrosarcoma protuberans. To corroborate these results, we sought to ascertain the utility of Apo D by investigating its sensitivity and specificity in a variety of CD34-positive and CD34-negative cutaneous neoplasms including superficial acral fibromyxoma, sclerotic fibromas, and cellular dermatofibromas. Of interest, we found absence of Apo D expression in all four cases of superficial acral fibromyxoma. Of the remaining CD34-positive lesions, Apo D expression was noted in 35/36 (97%) cases of dermatofibrosarcoma protuberans, 3/5 (60%) giant-cell fibroblastomas, 4/4 (100%) sclerotic fibromas, 8/8 (100%) neurofibromas, and 1/1 (100%) solitary fibrous tumor. Of the CD34-negative lesions, Apo D expression was noted in 2/22 (9%) regular dermatofibroma, 23/45 (51%) cellular dermatofibroma, 10/10 (100%) malignant fibrous histiocytoma, 9/10 (90%) atypical fibroxanthoma, 7/8 (86%) cellular neurothekeoma, 9/9 (100%) malignant melanoma, 8/8 (100%) melanocytic nevi (100%), 0/2 superficial angiomyxoma, 0/15 fibromatosis, 0/ 1 nodular fasciitis, and 1/2 (50%) desmoplastic fibroblastomas. In summary, our findings indicate that Apo D expression is not specific to dermatofibrosarcoma protuberans. Its principal use as an immunohistochemical adjunct lies in its utility in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans. Although strong positive staining of Apo D in a markedly atypical fibrohistiocytic lesion is suggestive of atypical fibroxanthoma and/or malignant fibrous histiocytoma, further studies with the inclusion of other atypical spindled cell neoplasms are required to conclusively prove the same.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Apolipoprotein D in CD34-positive and CD34-negative cutaneous neoplasms: a useful marker in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans

et al. 2008

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“…In up to one in five cases, the lesion may recur. 20,21 Microscopic examination reveals a dermal or subcutaneous proliferation composed of bland spindle and stellate cells within a myxoid or collagenous stroma with prominent vessels and mast cells. Cells are arranged in random, loose storiform and fascicular growth patterns ( Figure 6).…”

Section: Superficial Acral Fibromyxomamentioning

confidence: 99%

Acral manifestations of soft tissue tumors

Paral

Petronic‐Rosic

2017

Clinics in Dermatology

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This group of biologically diverse entities is united by topographic localization to the hands and feet. Categorizing tumors by body site narrows the differential into a short list of possibilities that can facilitate accurate and rapid diagnosis. The goal of this review is to provide a practical approach to soft tissue tumors of acral locations for clinicians, pathologists, and researchers alike. What ensues in the following text is that tight coupling of the clinical picture and histopathologic findings should produce the correct diagnosis, or at least an abbreviated differential. The salient clinicopathologic, immunohistochemical, and molecular features are presented alongside current treatment recommendations for each entity.

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Soft‐Tissue Tumours and Tumour‐Like Conditions

Calonje

2004

Rook's Textbook of Dermatology

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Superficial acral fibromyxoma: A clinicopathologic and immunohistochemical analysis of 37 cases of a distinctive soft tissue tumor with a predilection for the fingers and toes

Cited by 275 publications

References 22 publications

Apolipoprotein D in CD34-positive and CD34-negative cutaneous neoplasms: a useful marker in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans

Apolipoprotein D in CD34-positive and CD34-negative cutaneous neoplasms: a useful marker in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans

Acral manifestations of soft tissue tumors

Soft‐Tissue Tumours and Tumour‐Like Conditions

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