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DOJ Contents |
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Superficial acral fibromyxoma of the index finger
Dermatology Service, Department of Medicine, Walter Reed Army Medical Center, Washington, DC, USA |
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Superficial acral fibromyxoma is a newly characterized soft tissue tumor with a predilection for the nail region of the fingers and toes. We describe a man with a superficial acral fibromyxoma, the first such case reported in the dermatology literature, and review its clinical and histopathological characteristics. Under local anesthesia, the well-circumscribed mass was completely excised revealing a conical tumor extending 1-2 mm beyond the nail matrix. The five-millimeter wedge-shaped mass was fixed to the deeper structures of the index finger adjacent to the cuticle with its dorsal pole having a filliform appearance. Histologically, the overlying epidermis was acanthotic and hyperkeratotic. The tumor consisted of a proliferation of spindle-shaped and occasional stellate-shaped fibroblast-like cells in a myxocollagenous stroma. Focally, both myxoid and fascicular growth patterns were present. Mast cells were seen throughout the lesion, but other inflammatory cells were absent. Mitotic figures, multinucleate cells and cellular atypia were not evident. The neoplastic cells showed immunoreactivity to epithelial membrane antigen, vimentin, CD-99 and CD-34, but not to actin, desmin, S100, cytokeratin or HMB-45. Following excision, the lateral nail bed was re-approximated to the satisfaction of the patient. There has been no recurrence after three months of follow up. © 2002 Dermatology Online Journal |