Allison Hanlon1, Thomas Stasko, Dan Christiansen, Nika Cyrus, Anjela Galan. 1. *Division of Dermatology, Department of Medicine, Vanderbilt University, Nashville, Tennessee; †Department of Dermatology, University of Oklahoma, Oklahoma City, Oklahoma; ‡Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut.
Abstract
BACKGROUND: Atypical fibroxanthoma (AFX) is a rare cutaneous spindled cell neoplasm. For both diagnostic and therapeutic purposes, it is important to distinguish AFX from other poorly differentiated tumors, including undifferentiated pleomorphic sarcoma (UPS). OBJECTIVE: The authors aimed to identify the clinical, histologic, and immunohistochemical expression of LN2, ezrin, and CD10 in AFX and UPS tumors. METHODS AND MATERIALS: The authors retrospectively examined the charts of patients with AFX and UPS treated with Mohs micrographic surgery (MMS) at 2 academic institutions. Patient demographics, tumor characteristics, and clinical course data were collected. Immunohistochemical stains were performed on primary and recurrent AFX and UPS tumors with monoclonal antibodies against the B-cell marker LN2 (CD74), CD10, and ezrin. RESULTS: In the series of 169 patients with AFX included in this study, local recurrence was rare at 3%. In contrast, the seven patients with UPS had an aggressive clinical course with 1 local recurrence and 2 distant metastases. Immunohistochemistry staining for ezrin, LN2, and CD10 were similar in AFX and UPS tumors. CONCLUSION: AFX can be treated with MMS with rare instances of recurrence. Undifferentiated pleomorphic sarcoma has a more aggressive clinical course with increased risk for recurrence and metastasis. Staining with ezrin, LN2, and CD10 did not differentiate AFX or UPS tumors.
BACKGROUND:Atypical fibroxanthoma (AFX) is a rare cutaneous spindled cell neoplasm. For both diagnostic and therapeutic purposes, it is important to distinguish AFX from other poorly differentiated tumors, including undifferentiated pleomorphic sarcoma (UPS). OBJECTIVE: The authors aimed to identify the clinical, histologic, and immunohistochemical expression of LN2, ezrin, and CD10 in AFX and UPS tumors. METHODS AND MATERIALS: The authors retrospectively examined the charts of patients with AFX and UPS treated with Mohs micrographic surgery (MMS) at 2 academic institutions. Patient demographics, tumor characteristics, and clinical course data were collected. Immunohistochemical stains were performed on primary and recurrent AFX and UPS tumors with monoclonal antibodies against the B-cell marker LN2 (CD74), CD10, and ezrin. RESULTS: In the series of 169 patients with AFX included in this study, local recurrence was rare at 3%. In contrast, the seven patients with UPS had an aggressive clinical course with 1 local recurrence and 2 distant metastases. Immunohistochemistry staining for ezrin, LN2, and CD10 were similar in AFX and UPS tumors. CONCLUSION:AFX can be treated with MMS with rare instances of recurrence. Undifferentiated pleomorphic sarcoma has a more aggressive clinical course with increased risk for recurrence and metastasis. Staining with ezrin, LN2, and CD10 did not differentiate AFX or UPS tumors.
Authors: Klaus G Griewank; Thomas Wiesner; Rajmohan Murali; Carina Pischler; Hansgeorg Müller; Christian Koelsche; Inga Möller; Cindy Franklin; Ioana Cosgarea; Antje Sucker; Dirk Schadendorf; Jörg Schaller; Susanne Horn; Thomas Brenn; Thomas Mentzel Journal: Mod Pathol Date: 2017-11-03 Impact factor: 7.842
Authors: Omar Al Laham; Gheed Abdul Khalek; Hazar Alboushi; Abd Al Hameed Al Mohammad; Mohamad Almaydaani; Alaa Alhanwt Journal: Int J Surg Case Rep Date: 2022-09-19
Authors: Mathias Ørholt; Frederik L Aaberg; Kiya Abebe; S Walsh; Randall K Roenigk; Alessandro Venzo; Grethe Schmidt; Helle Klyver; David H Jensen; Mikkel Herly; Peter V Vester-Glowinski Journal: J Surg Oncol Date: 2022-04-19 Impact factor: 2.885