RESUMEN
BACKGROUND: The spindle epithelial tumor with thymuslike differentiation (SETTLE) is a rare thyroid tumor believed to be derived from ectopic thymus tissue or the embryonic remnants of branchial pouches, which displays primitive thymic differentiation. Histologic observation of spindle cells may lead to confusion with other tumors the development and prognosis of which are very different. Differential diagnosis using histochemical markers is essential since although there is a tendency to develop blood-borne metastases, tumor growth is slow and the survival rate in patients followed up is as high as 70%. It mainly affects children and young adults (mean age 15), although cases have been reported in patients ranging from 2 to 59. CASE: A 2-year-old boy presented with a tumor on the anteroinferior aspect of the neck, which had been growing since birth, suggesting a congenital origin. Histologic examination showed spindle cell nodules separated by fibrous bands containing mucous glands and cysts filled with mucoid material. Immunohistochemical markers revealed primitive differentiation; tumor cells stained positive for cytokeratin and vimentin but negative for markers indicative of greater differentiation, such as calcitonin, chromogranin, calretinin, synaptophysin and S-100 protein. CONCLUSION: This is the first reported case of SETTLE in the youngest patient which had been growing since birth.
Asunto(s)
Neoplasias Glandulares y Epiteliales/patología , Timoma/patología , Timo/patología , Neoplasias del Timo/patología , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Biomarcadores de Tumor/metabolismo , Transformación Celular Neoplásica , Preescolar , Humanos , Inmunohistoquímica , Masculino , Neoplasias Glandulares y Epiteliales/metabolismo , Neoplasias Glandulares y Epiteliales/cirugía , Timoma/metabolismo , Timoma/cirugía , Timo/metabolismo , Neoplasias del Timo/metabolismo , Neoplasias del Timo/cirugía , Glándula Tiroides/metabolismo , Neoplasias de la Tiroides/metabolismo , Neoplasias de la Tiroides/cirugíaRESUMEN
Myxoinflammatory fibroblastic sarcoma of the soft tissues is a rare low-grade tumor of uncertain origin that most often occurs on the extremities of adults. The tumor predominantly involves the subcutaneous tissues of the hands and feet. Despite being a rare neoplasm, owing to its varied histologic appearance, myxoinflammatory fibroblastic sarcoma should be differentiated from various benign and malignant soft-tissue lesions. Myxoinflammatory fibroblastic sarcoma has been well described in pathology journals but not in the surgical literature. We report a case of myxoinflammatory fibroblastic sarcoma in a 19-year-old man with a plantar ulcer lesion in his left foot. To our knowledge, this is the first reported case in the literature involving the epidermis.