Öz
Atipik fibroksantom nadir görülen, düşük dereceli bir neoplazm olup, sıklıkla güneşe maruz kalan yaşlı hastalarda görülmektedir. Fibroblastlardan kaynaklanan bu hastalığın tanısında klinik, histopatolojik ve immünokimyasal özelliklerinin incelenmesi ve böylece karsinom, melanom, malign fibröz histiyositom gibi malign bazı tanılardan ayrılması gerekmektedir. Olguların büyük çoğunluğu benign olup metastaza nadir olarak rastlanmaktadır. Çalışmamızda 75 yaşında bir erkek hastada 1,5 ay önce parietal alanda ortaya çıkan, başvuru sırasında palpasyonla sert üzeri hafif kanamalı ağrısız nodüler lezyon ile prezente olan atipik fibroksantom olgusu klinik ve patolojik bulgular eşliğinde sunulmuştur. Olgunun metastatik lezyonu, lenfovasküler veya derin invazyonu bulunmamaktadır. Tartışma bölümünde vaka ayırıcı tanı açısından diğer bir takım hastalıklarla histopatolojik ve immünokimyasal olarak karşılaştırılmıştır. Son olarak seçilen cerrahi tedavi yöntemin yeterliliği değerlendirilmiştir.
Anahtar Kelimeler
Kaynakça
- Helwig EB. Atypical fibroxanthoma. Proceedings of the 18thAnnual Tumor Seminar of San Antonio Socaiety of Pathologists, 1961. Tex State J Med 1963;59:664.
- Weiss SW, Goldblum JR. Malignant fibrohistiocytic tumors. In: Strauss M, ed. Enzinger and Weiss’s Soft Tissue Tumors, 6th edn. St Louis: Mosby, 2014:535-69.
- Freedberg IM, Eise AZ, Wolff K, et al. Atypical fibroxanthoma. In: Freedberg I, ed. Fitzpatrick’s Dermatology in General Medicine, 6th edn. New York: McGraw Hill Professional, 2003:998.
- Heenan PJ. Tumors of the fibrous tissue involving the skin.Elder D, Elenitsas R, Jaworsky C, Johnson B eds. In: Lever’s histopathology of the skin. Eight edition. Philadelphia: Lippincott- Raven, 1997: 847-88.
- Helwig EB, May D. Atypical fibroxanthoma of the skin withmetastasis. Cancer 1986; 57: 368.
- Fretzin DF, Helwig EB, Atypical fibroxanthoma of the skin.Cancer 1973; 31; 1541.
- Murali R, Palfreeman S. Clear cell atypical fibroxanthoma –report of a case with review of the literature. J Cutan Pathol 2006;33:343-8.
- Wilson PR, Strutton GM, Steawart MR. Atypical fibroxanthoma: two unusual variants. J Cutan Pathol 1989; 16:93-8.
- Zelger BG, Soyer HP, Zelger B. Giant cell atypical fibroxanthoma: Does it really exist? Am J Dermatopathol; 1999; 21: 108-9.
- Khan ZM, Cockerell CJ. Atypical fibroxanthoma withosteoclast-like multinucleated giant cells. Am J Dermatopathol 1997; 19: 174-9.
- Tomaszewski MM, Lupton GP. Atypical fibroxanthoma. Anunusual variant with osteoclast-like giant cells. Am J Surg Pathol 1997; 21: 213-8.
- Ang GC, Roenigk RK, Otley CC, Kim Phillips P, WeaverAL.More than 2 decades of treating atypical fibroxanthoma at mayo clinic: what have we learned from 91 patients? Dermatol Surg. 2009 May;35(5):765-72
Öz
Atypical fibroxanthoma is an uncommon neoplasm generally found in elderly patients on sun-exposed areas. Both clinical, histopathological and immunohistochemical features of this fibroblastic process should be assessed in order to be able to diagnose and differentiate it from a number of malignant entities such as carcinoma, melanoma and malignant fibrous histiocytoma. The majority of cases of atypical fibroxanthoma are benign, and metastasis is a rare phenomenon. In this report a 75 year old male patient complaining of a parietally located, painless, mildly hemorrhagic, hard nodular lesion for 1,5 month diagnosed as atypical fibroxanthoma is presented with its clinical and histopathological findings. There was no metastatic lesion, lymphovascular and deep invasion areas microscopically. In the discussion part, the diagnosis was compared with some other entities in histopathological and immunohistochemical manner with regard to differential diagnosis. Lastly the adequacy of the chosen surgical method for the case is discussed and commented.
Anahtar Kelimeler
Kaynakça
- Helwig EB. Atypical fibroxanthoma. Proceedings of the 18thAnnual Tumor Seminar of San Antonio Socaiety of Pathologists, 1961. Tex State J Med 1963;59:664.
- Weiss SW, Goldblum JR. Malignant fibrohistiocytic tumors. In: Strauss M, ed. Enzinger and Weiss’s Soft Tissue Tumors, 6th edn. St Louis: Mosby, 2014:535-69.
- Freedberg IM, Eise AZ, Wolff K, et al. Atypical fibroxanthoma. In: Freedberg I, ed. Fitzpatrick’s Dermatology in General Medicine, 6th edn. New York: McGraw Hill Professional, 2003:998.
- Heenan PJ. Tumors of the fibrous tissue involving the skin.Elder D, Elenitsas R, Jaworsky C, Johnson B eds. In: Lever’s histopathology of the skin. Eight edition. Philadelphia: Lippincott- Raven, 1997: 847-88.
- Helwig EB, May D. Atypical fibroxanthoma of the skin withmetastasis. Cancer 1986; 57: 368.
- Fretzin DF, Helwig EB, Atypical fibroxanthoma of the skin.Cancer 1973; 31; 1541.
- Murali R, Palfreeman S. Clear cell atypical fibroxanthoma –report of a case with review of the literature. J Cutan Pathol 2006;33:343-8.
- Wilson PR, Strutton GM, Steawart MR. Atypical fibroxanthoma: two unusual variants. J Cutan Pathol 1989; 16:93-8.
- Zelger BG, Soyer HP, Zelger B. Giant cell atypical fibroxanthoma: Does it really exist? Am J Dermatopathol; 1999; 21: 108-9.
- Khan ZM, Cockerell CJ. Atypical fibroxanthoma withosteoclast-like multinucleated giant cells. Am J Dermatopathol 1997; 19: 174-9.
- Tomaszewski MM, Lupton GP. Atypical fibroxanthoma. Anunusual variant with osteoclast-like giant cells. Am J Surg Pathol 1997; 21: 213-8.
- Ang GC, Roenigk RK, Otley CC, Kim Phillips P, WeaverAL.More than 2 decades of treating atypical fibroxanthoma at mayo clinic: what have we learned from 91 patients? Dermatol Surg. 2009 May;35(5):765-72
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Nisan 2018 |
| Kabul Tarihi | 16 Mart 2016 |
| Yayımlandığı Sayı | Yıl 2018 |
Kaynak Göster
