Superficial acral fibromyxoma
| Superficial acral fibromyxoma | |
|---|---|
| Specialty | Dermatology |
A superficial acral fibromyxoma is a type of myxoma and is a rare cutaneous condition characterized by a mesenchymal neoplasm that typically occurs on the digits of middle-aged adults.[1]: 1817
Signs and symptoms
[edit]Superficial acral fibromyxoma impacts the palm, heel, and ankle in addition to the acral regions, with a clear preference for the periungual and subungual regions of the fingers and toes.[2] It begins as a slow-growing, solitary nodule limited to the dermis and subcutaneous tissue, and it is typically painless.[3] They range in size from 0.6-5 cm.[4] Fifty percent of the cases involve the nails, exhibiting either onycholysis or hyperkeratosis.[5]
Causes
[edit]Although a precise cause has not been identified, history of trauma is uncommon and has been documented.[6]
Diagnosis
[edit]A histologic examination reveals stellate and spindled fibroblast-like cells proliferating moderately within a myxoid and/or collagenous matrix with prominent microvasculature.[7] There may be a hyperkeratotic overlaying epidermis.[8][9] The tumor cells are distributed in a focally fascicular and loose storiform pattern.[4] This tumor can be positively stained with CD34,[10] CD99, vimentin, and CD10.[7]
Differential diagnosis includes periungual and subungual fibroma, acquired digital fibrokeratoma, superficial angiomyxoma, myxoid neurofibroma, dermal mucinosis, sclerosing perineuroma, low grade fibromyxoid sarcoma, myxoid dermatofibrosarcoma protuberans, fibroma of tendon sheath, giant cell tumour, glomus tumour, fibrous histiocytoma, cutaneous myxoma and inflammatory myxohyaline tumour of distal extremities.[7]
Treatment
[edit]Complete excision, which typically prevents recurrence, and regular follow-up are recommended surgical therapy techniques.[7]
Outlook
[edit]Superficial acral fibromyxoma has a benign course.[3] Though it is possible for the tumor to convert into a low-grade malignant tumor, no malignant transition has been documented till 2001.[10][11] There have been reports of 22–24% local recurrence rates.[4][12]
Epidemiology
[edit]The majority of affected individuals are young adults (mean age: 46 years), with a 2:1 male to female ratio.[6]
See also
[edit]References
[edit]- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
- ^ Park, Se-Won; Kim, Jun-Hwan; Shin, Hyun-Tae; Park, Ji Ho; Lee, Jong-Hee; Lee, Dong-Youn; Lee, Joo-Heung; Yang, Jun-Mo (2014). "Superficial Acral Fibromyxoma on the Palm". Annals of Dermatology. 26 (1). Korean Dermatological Association and The Korean Society for Investigative Dermatology: 123. doi:10.5021/ad.2014.26.1.123. ISSN 1013-9087. PMC 3956782. PMID 24648703.
- ^ a b Debordes, Pierre-Antoine; Hamoudi, Ceyran; Weingertner, Noelle; Di Marco, Antonio (2023-02-01). "Superficial acral fibromyxoma: a case of missed diagnosis". Journal of Surgical Case Reports. 2023 (2): rjad027. doi:10.1093/jscr/rjad027. ISSN 2042-8812. PMC 9894613. PMID 36751671.
- ^ a b c Fetsch, John F.; Laskin, William B.; Miettinen, Markku (2001). "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". Human Pathology. 32 (7). Elsevier BV: 704–714. doi:10.1053/hupa.2001.25903. ISSN 0046-8177. PMID 11486169.
- ^ C, Ramya; Nayak, Chitra; Tambe, Swagata (2016). "Superficial acral fibromyxoma". Indian Journal of Dermatology. 61 (4). Medknow: 457–459. doi:10.4103/0019-5154.185734. ISSN 0019-5154. PMC 4966414. PMID 27512201.
- ^ a b Goo, Jawoong; Jung, Ye-Jin; Kim, Jae-Hong; Lee, Sung-yul; Ahn, Sung Ku (2010). "A Case of Recurrent Superficial Acral Fibromyxoma". Annals of Dermatology. 22 (1). Korean Dermatological Association and The Korean Society for Investigative Dermatology: 110. doi:10.5021/ad.2010.22.1.110. ISSN 1013-9087. PMC 2883388. PMID 20548898.
- ^ a b c d Ashby-Richardson, Harty; Rogers, Gary S; Stadecker, Miguel J (2011-08-01). "Superficial Acral Fibromyxoma: An Overview". Archives of Pathology & Laboratory Medicine. 135 (8): 1064–1066. doi:10.5858/2009-0684-RSR1. ISSN 0003-9985. PMID 21810002.
- ^ Meyerle, CPT Jon H; Keller, COL Richard A; Krivda, LTC Stephen J (2004). "Superficial acral fibromyxoma of the index finger". Journal of the American Academy of Dermatology. 50 (1). Elsevier BV: 134–136. doi:10.1016/s0190-9622(03)00761-8. ISSN 0190-9622. PMID 14699384.
- ^ Kazakov, D.V.; Mentzel, T.; Burg, G.; Kempf, W. (2002). "Superficial Acral Fibromyxoma: Report of Two Cases". Dermatology. 205 (3). S. Karger AG: 285–288. doi:10.1159/000065853. ISSN 1018-8665.
- ^ a b Hollmann, Travis J.; Bovée, Judith V.M.G.; Fletcher, Christopher D.M. (2012). "Digital Fibromyxoma (Superficial Acral Fibromyxoma)". American Journal of Surgical Pathology. 36 (6). Ovid Technologies (Wolters Kluwer Health): 789–798. doi:10.1097/pas.0b013e31824a0b83. ISSN 0147-5185. PMID 22367301.
- ^ Crepaldi, Bruno Eiras; Soares, Ruan Dalbem; Silveira, Fábio Duque; Taira, Raul Itocazo; Hirakawa, Celso Kiyoshi; Matsumoto, Marcelo Hide (2019). "Fibromixoma acral superficial: Revisão da Literatura". Revista Brasileira de Ortopedia (in Portuguese). 54 (5). Georg Thieme Verlag KG: 491–496. doi:10.1016/j.rbo.2017.10.011. ISSN 0102-3616. PMC 6856000.
- ^ Al-Daraji, Wael I; Miettinen, Markku (2008-10-10). "Superficial acral fibromyxoma: a clinicopathological analysis of 32 tumors including 4 in the heel". Journal of Cutaneous Pathology. 35 (11). Wiley: 1020–1026. doi:10.1111/j.1600-0560.2007.00954.x. ISSN 0303-6987. PMID 18537858.
Further reading
[edit]- Gupta, Ravi; Malhotra, Anubhav; Arora, Sonam; Bansal, Vinisha (2018). "Superficial acral fibromyxoma: A rare and distinct clinicopathological entity: A case report and review of literature". Human Pathology: Case Reports. 12. Elsevier BV: 16–18. doi:10.1016/j.ehpc.2017.12.006. ISSN 2214-3300.
- Sundaramurthy, Narayanamurthy (2016). "Superficial Acral Fibromyxoma: A Rare Entity - A Case Report". Journal of Clinical and Diagnostic Research. JCDR Research and Publications. doi:10.7860/jcdr/2016/19540.8440. ISSN 2249-782X. PMC 5072012. PMID 27790512.