Ossifying fibromyxoid tumor of the skin: A report of 2 cases with light microscopic, immunohistochemical, and electron microscopic characterization

Department of Dermatology, University of Southern California-Keck School of Medicine, Los Angeles, California, USA.
Journal of the American Academy of Dermatology (Impact Factor: 5). 05/2005; 52(4):644-7. DOI: 10.1016/j.jaad.2004.11.053
Source: PubMed

ABSTRACT Ossifying fibromyxoid tumor is a rare fibro-osseous neoplasm occurring predominantly in the subcutaneous tissue and/or skeletal muscle of the extremities. The immunohistochemical and ultrastructural studies in reported cases favor neural or Schwannian origin. To date, ossifying fibromyxoid tumor presenting as a primary skin tumor has not been described in the literature. Two cases of primary cutaneous ossifying fibromyxoid tumor with light microscopic, immunohistochemical, and ultrastructural characterization are presented. Our observations also support neural differentiation of these tumors.

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    ABSTRACT: We present a case of an ossifying fibromyxoid tumor (OFMT) with malignant features. This neoplasm was discovered in the thigh of a 53-year-old woman whose only complaint was of mild discomfort. The patient was aware of the mass for 5 years however, recent rapid growth of the lesion prompted her to seek medical attention. We discuss the clinical, histopathologic and radiologic findings of this rare tumor and briefly review pertinent scientific literature.
    European Journal of Radiology Extra 05/2007; DOI:10.1016/j.ejrex.2007.02.005
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    ABSTRACT: INTRODUCTION Ossifying fibromyxoid tumor (OFMT) is an uncommon soft tissue and bone neoplasm with just over 100 cases being reported in the literature. They present as small, slow-growing asymptomatic subcutaneous nodules in the soft tissues of the trunk and extremities. PRESENTATION OF CASE We present a case of a 25-year-old, right hand dominant gentleman who complained of a seven-year history of pain and discomfort in the dorsal aspect of the right thumb. He was unable to move his interphalangeal joint (IPJ) but had good function otherwise. Examination revealed a localized tender swelling over the dorsal aspect of the IPJ. The thumb was fixed in extension. X-ray revealed marked abnormal soft tissue swelling around the interphalangeal joint, cystic abnormalities and new bone formation. Biopsy showed fibrous tissue containing nodules of tumor with cells in a myxoid background, rounded and histiocytoid to elongated and spindle shaped. CD57, type IV collagen, smooth muscle actin were found and CD56 and EMA were focally positive. These were in keeping with ossifying fibromyxoid tumor with an atypical immunophenotype. DISCUSSION The tumor was formally excised with the flexor pollicis longus tendon. A two-month review revealed his pain had settled. As the tumor had an atypical immunophenotype he was referred to the regional sarcoma team. CONCLUSION OMFT can present with atypical clinical, radiological and histological features. It is managed in a multidisciplinary setting and often requires lifetime follow up to detect a recurrence given the uncertain nature of these lesions.
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    ABSTRACT: A 76-year-old woman presented with a well-circumscribed 3 cm mass of her right buttock. The tumor, partially surrounded by a shell of woven and lamellar bone, had a lobular arrangement of highly cellular islands of tumor cells embedded in a variably fibrous to myxoid stroma. The lesional cells had well defined cytoplasmic membranes with varying amounts of clear to lightly eosinophilic cytoplasm. The nuclei exhibited moderate to severe nuclear atypia. Areas of tumor necrosis were present. The mitotic rate was 17 MF/50 high-power fields. The tumor was diagnosed as an ossifying fibromyxoid tumor (OFMT). OFMT is a rare tumor first described in 1989. Although OFMT usually occurs in deep soft tissue, up to 11% of reported lesions presented as cutaneous tumors. OFMT usually present in adults on the extremities or trunk. Most are histologically bland and apparently benign tumors, but OFMT with high nuclear grade, high cellularity, and >2 MF/50 high-power fields have shown potential for aggressive behavior including metastasis. OFMT with these features should be considered sarcomas. Given the histologic features, this tumor was considered a malignant OFMT. The patient had a wide excision. The patient died secondary to unrelated comorbidities without evidence of recurrence or metastasis.
    American Journal of Dermatopathology 04/2007; 29(2):156-9. DOI:10.1097/ · 1.43 Impact Factor