Natasha Atanaskova Mesinkovska1, Darya Buehler2, Colt M McClain3, Brian P Rubin4, John R Goldblum4, Steven D Billings4. 1. Department of Dermatology, Cleveland Clinic, Cleveland, OH, USA. 2. Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. 3. Department of Pathology, Baylor College of Medicine, Houston, TX, USA. 4. Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.
Abstract
INTRODUCTION: Ossifying fibromyxoid tumor (OFMT) is rare and may present diagnostic difficulty. We describe 26 subcutaneous examples of OFMT emphasizing differential diagnosis and prognostic features. METHODS: Histopathology and follow-up data from archival/consultation cases were reviewed. Prognostic features were assessed according to proposed criteria. RESULTS: Patients (16 female, 10 male) ranged from 26 to 88 years (median 54). The tumors (median 2.3 cm, range 0.8-8.5) involved lower limb (11), trunk (7), head/neck (4), or arm (4). All showed combinations of corded, nested and trabecular patterns in a fibromyxoid stroma. Out of 26 cases 13 had peripheral ossification. Sixteen of 22 cases showed S100 protein expression. Nuclear grade was low (14); intermediate (8) and high (4) while cellularity was low (14); moderate (7) and high (5), with overall good interobserver agreement. Median mitotic rate was 3/50HPF (0-61). Five met criteria for malignant OFMT showing high nuclear grade or high cellularity and mitotic rate >2/50HPF or both. Thirteen OFMTs were atypical. Follow-up (16/26, median 45.5 months, range 8-108) showed that patients with typical OFMT (3) and atypical OFMT (9) remained disease-free. Three malignant examples of OFMT recurred and one metastasized to the lung. No deaths were recorded. CONCLUSIONS: Our results validate proposed prognostic classification of OFMT. Dermatopathologists should be aware of this unusual superficial tumor given its potentially aggressive behavior.
INTRODUCTION: Ossifying fibromyxoid tumor (OFMT) is rare and may present diagnostic difficulty. We describe 26 subcutaneous examples of OFMT emphasizing differential diagnosis and prognostic features. METHODS: Histopathology and follow-up data from archival/consultation cases were reviewed. Prognostic features were assessed according to proposed criteria. RESULTS:Patients (16 female, 10 male) ranged from 26 to 88 years (median 54). The tumors (median 2.3 cm, range 0.8-8.5) involved lower limb (11), trunk (7), head/neck (4), or arm (4). All showed combinations of corded, nested and trabecular patterns in a fibromyxoid stroma. Out of 26 cases 13 had peripheral ossification. Sixteen of 22 cases showed S100 protein expression. Nuclear grade was low (14); intermediate (8) and high (4) while cellularity was low (14); moderate (7) and high (5), with overall good interobserver agreement. Median mitotic rate was 3/50HPF (0-61). Five met criteria for malignant OFMT showing high nuclear grade or high cellularity and mitotic rate >2/50HPF or both. Thirteen OFMTs were atypical. Follow-up (16/26, median 45.5 months, range 8-108) showed that patients with typical OFMT (3) and atypical OFMT (9) remained disease-free. Three malignant examples of OFMT recurred and one metastasized to the lung. No deaths were recorded. CONCLUSIONS: Our results validate proposed prognostic classification of OFMT. Dermatopathologists should be aware of this unusual superficial tumor given its potentially aggressive behavior.
Authors: Salvatore Provenzano; Alessandra Raimondi; Rossella M Bertulli; Vittoria Colia; Salvatore L Renne; Paola Collini; Gianpaolo Dagrada; Dario Callegaro; Marco Fiore; Francesca G Greco; Paolo G Casali Journal: Clin Sarcoma Res Date: 2017-12-28
Authors: Maria Eduarda Pérez-de-Oliveira; Thayná Melo de Lima Morais; Márcio Ajudarte Lopes; Oslei Paes de Almeida; Willie F P van Heerden; Pablo Agustin Vargas Journal: Autops Case Rep Date: 2020-12-08