Ectomesenchymal chondromyxoid tumor of the anterior aspect of the tongue.

Department of Dermatology, Marmara University School of Medicine, Istanbul, Turkey.
Journal of the American Academy of Dermatology (Impact Factor: 4.91). 09/2008; 59(2 Suppl 1):S23-4. DOI: 10.1016/j.jaad.2007.09.033
Source: PubMed

ABSTRACT Ectomesenchymal chondromyxoid tumor of the anterior aspect of the tongue is a benign rare tumor. Thirty cases have been reported so far. It presents as a slowly growing, asymptomatic, submucosal nodule on the anterior dorsum of the tongue. Histopathologically, the tumor is composed of a well-circumscribed, lobular proliferation of fusiform and ovoid cells in a chondromyxoid background. Most consistent immunohistochemical finding is the diffuse and strong immunoreactivity for glial fibrillary acid protein. Histogenetic origin of the tumor is uncertain. We report here a 56-year-old woman with a 0.7-cm tumoral lesion of 5 months' duration on the anterior aspect of her tongue. Total excision was performed and histopathologic findings were consistent with ectomesenchymal chondromyxoid tumor. No recurrence was observed after 2 years of follow-up.

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    ABSTRACT: An ectomesenchymal chondromyxoid tumor (ECMT) is a rare neoplasm that exclusively occurs in the anterior dorsum of the tongue. The tumor consists of small round to fusiform or spindle cells with myxoid or chondroid stroma. The tumor consistently shows a positive reaction with glial fibrillary acidic protein antibodies, especially polyclonal antibodies. We report 2 cases of reticulated myxoid tumors arising in the tongue. One tumor occurred in the posterior dorsum of the tongue and another in the anterior. Both tumors showed characteristic morphology of ECMT; however, both were negative for reactions with monoclonal and polyclonal glial fibrillary acidic protein antibodies. On the basis of morphology, they are thought to be belonging to ECMT. Hence, we suggest that ECMT can show broader spectrum of clinical and immunophenotypic feature.
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    ABSTRACT: chondromyxoid tumour (ECT) of the anterior tongue was first described in 1995 by SMITH et al. 3 The report included 19 tumours, all located in the anterior dorsal surface of the tongue underneath the lingual mucosa. The tumours were characterized histologically by circumscription and lobular prolifera-tion of ovoid and fusiform cells, which often had multi-lobulated nuclei and occasional foci of atypia, in a chondro-myxoid background. The immunohisto-chemical profile showed intense and diffuse positivity for glial fibrillary acidic protein (GFAP), and general reactivity for cytokeratin. There was variable stain-ing for S-100 protein, smooth muscle actin (SMA) and CD-57 (Leu-7), but staining for desmin and epithelial mem-brane antigen (EMA) were negative. On the basis of these features, the authors were able to distinguish ECT from other myxoid or chondroid soft-tissue lesions. Since the initial report, four more cases of ECT have been reported by KANNAN et al. 2 and VAN DER WAL & VAN DER WAL 4 . All had the clinical and histo-logic features described by SMITH et al. 3 , except they were negative for cytokera-tin. In these studies a cytokeratin cock-tail antibody (AE-1/AE-3) was used for the immunohistochemistry analysis 2–4 . In the original article most of the tumours were positive for keratin, but data on the proportion of tumour cells stained were not given. Over the last 5 years, two patients have presented with asymptomatic soft-tissue masses in the anterior dorsal surface of the tongue. The lesions had the typical architectural and cytological characteris-tics of ECT, were positive for GFAP and S-100 protein, but were negative for the cytokeratin cocktail. The purpose of the present study was to further investigate the expression of cytokeratin in ECT by using a panel of monoclonal antibodies against several types of keratin, which are expressed in different patterns in tumours of varying origin.
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