Guerra Karla C, Godwin Luke, Johnston Chad, Noland Maggie, Rowe David
LewisGale Hospital Montgomery, Blacksburg, VA.
University of Virginia, Department of Dermatology, Charlottesville, VA.
HCA Healthc J Med. 2021 Aug 29;2(4):273-277. doi: 10.36518/2689-0216.1288. eCollection 2021.
Description The following case study demonstrates a 26-year-old male that presented to the dermatology clinic with an enlarging, raised skin nodule located on the left inferior lateral lower back. The patient reported it had persisted for two years, and he had not received prior treatment. He noted a family history of nonmelanoma skin cancer but had no other dermatological issues in the past. Physical examination revealed a pink, firm and well-circumscribed subcutaneous mass with a prominent follicular pore. It was assumed the lesion was an epidermal inclusion cyst, and surgical excision was performed. Histopathology revealed lobules of epithelioid cells with indistinct cytoplasm in a fibromyxoid hyalinized matrix surrounded by lamellar bone and a collagenous pseudocapsule. Immunohistochemical staining showed moderate desmin immunoreactivity and negative immunoreactivity for CD34, S-100, EMA, actin and pancytokeratin. Based on the findings, a diagnosis of ossifying fibromyxoid tumor was made. Given the uncertain biological potential of this lesion, re-excision was performed. No residual tumor was identified on repeat pathological evaluation. The patient was scheduled for close follow-up to survey for recurrence or possible metastasis.
病例描述 以下病例研究展示了一名26岁男性,他前往皮肤科诊所就诊,其左下背部外侧有一个不断增大的隆起性皮肤结节。患者报告该结节已持续两年,且此前未接受过治疗。他提到有非黑色素瘤皮肤癌家族史,但过去没有其他皮肤病问题。体格检查发现一个粉红色、质地坚实且边界清晰的皮下肿块,有一个明显的毛囊孔。初步推测该病变为表皮样囊肿,并进行了手术切除。组织病理学显示在纤维黏液样玻璃样变基质中有上皮样细胞小叶,细胞质不明显,周围有板层骨和胶原性假包膜。免疫组化染色显示结蛋白呈中度免疫反应性,而CD34、S-100、EMA、肌动蛋白和全细胞角蛋白呈阴性免疫反应性。根据这些发现,诊断为骨化性纤维黏液样肿瘤。鉴于该病变生物学潜能不确定,进行了再次切除。再次病理评估未发现残留肿瘤。患者被安排密切随访,以监测复发或可能的转移情况。