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RESIDENT
CASE
STUDIES
September 11,
2003: Case 3 Table
of Contents | List
of Diagnoses | Case 1 | Case 2 |
Case
3 | Case 4
10-year-old male with a right buttock mass
Discussion by Erin Thibault, MD
Superficial angiomyxoma is a dermal-based, well circumscribed,
multilobulated tumor which contains fibroblasts, thin walled vessels
(chicken wire), myxoid matrix and an epithelial component. These tend to
recur if not completely excised.
Distribution: Slightly more common
in males, predominantly middle aged adults.
Gross Appearance: Well-circumscribed,
dermal based nodule which is multilobulated. Myxoid appearance on cut
surface.
Microscopic
Appearance:
- Superficial angiomyxoma is composed of
fibroblasts (spindled or stellate shaped cells) which are embedded in
a myxoid matrix.
- Also present are prominent thin walled ("chicken
wire") vessels.
- Lastly, is an epithelial component which
is present in up to 1/3 of cases. These are thought to be entrapped
adnexal structures.
- There are rare mitotic figures.
- Inconspicuous nucleoli and stromal
neutrophils may be present.
Differential Diagnosis:
- Aggressive angiomyxoma
- Low-grade myxofibrosarcoma
- Myxiod liposarcoma
- Dermal nerve sheath myxoma
References:
- Kempson, Fletcher, Evans, Hendrickson,
and Sibley: Atlas of Tumor Pathology, AFIP, Tumors of the Soft
Tissues, third series, Vol. 30.
- Weiss SW, Goldblum JR. Enzinger and Weiss’s soft tissue tumor. 4th Eds.
Mosby.
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