Lung adenocarcinoma metastasizing to fibrous histiocytoma: A case report.

RATIONALE: Tumor-to-tumor metastasis is an uncommon phenomenon, and the tumor metastatic to mesenchymal tumor is extremely rare. To our knowledge, this is the first case of lung adenocarcinoma metastasizing to fibrous histiocytoma. PATIENT CONCERNS: A 58-year-old Chinese woman was admitted to our hospital with a complaint of progressive enlargement of a mass in the right upper arm without pain, heat (localized warmth), redness, and swelling, for a year. DIAGNOSES: Ultrasound revealed a mass with relative clear boundary in the right upper arm near elbow joint. Uneven echoes, and blood flow signals were showed within the mass. The tumor was well-demarcated from the surrounding tissue a thin fibrous capsule. Scattered enlarged cells with hyperchromatic pleomorphic nuclei were dispersed in an otherwise typical cutaneous fibrous histiocytoma. These atypical cells arranged in poorly glandular structures or irregular epithelioid nest and were demonstrated as metastatic lung adenocarcinoma by immunohistochemical staining. We reviewed the biopsy section and found these 2 sites of adenocarcinoma shared similar histologic morphological features. Therefore, the final diagnosis was lung adenocarcinoma metastasizing to fibrous histiocytoma. INTERVENTIONS: The patient was diagnosed with lung adenocarcinoma by bronchoscopic biopsy 3 months ago and received 4 cycles of NP (Vinoreltraye [NVB] + cis-platinum) chemotherapy program. The patient underwent a total resection of the mass in right upper arm. OUTCOMES: The patient died of multiple organ failure after 10 months since she was diagnosed as lung adenocarcinoma. LESSONS: The accumulation of lipid droplets in fibrous histiocytoma may be a potential reason for modifying pre-metastatic niche, and therefore create a tumor microenvironment suitable for metastasis.

Atypical Fibroxanthoma: The Washington University Experience.

BACKGROUND: Atypical fibroxanthoma (AFX) is a rare dermal neoplasm typically occurring on sun-exposed skin in the elderly. As AFX remains a diagnosis of exclusion, updated characterization and treatment assessments are necessary to support informed diagnosis and management. OBJECTIVE: Characterization of contemporary AFX and surgical outcomes by Mohs micrographic surgery (MMS) and conventional local excision (LE). METHODS: Retrospective cohort analysis of all cases of AFX at our institution from January 2000 through July 2016. RESULTS: Among 75 cases with median age at diagnosis 73 years, most occurred on the head and neck (68) independent of age. Most treated cases (42) underwent MMS alone, with median tissue removal greater for LE (2.6 cm, 4.5 cm) than MMS (0.6 cm, 1.2 cm). Over a median 26 months of follow-up, 6 recurrences were observed among 50 cases, with metastases in 2 cases. Intent-to-treat recurrence rates were 3.4% for MMS and 25% for LE. One nonrecurrent and 2 recurrent cases received revised diagnoses after initial treatment, yielding a true recurrence rate of 8.5%. CONCLUSION: Despite diagnostic confounding by similar pathologies, surgical treatment of AFX remains effective. Tissue-sparing resection by MMS affords the potential for cosmetic and reconstructive advantage, without compromising recurrence compared with conventional excision.

Generation of a TP53-modified porcine cancer model by CRISPR/Cas9-mediated gene modification in porcine zygotes via electroporation.

TP53 (which encodes p53) is one of the most frequently mutated genes in cancers. In this study, we generated TP53-mutant pigs by gene editing via electroporation of the Cas9 protein (GEEP), a process that involves introducing the Cas9 protein and single-guide RNA (sgRNA) targeting exon 3 and intron 4 of TP53 into in vitro-fertilized zygotes. Zygotes modified by the sgRNAs were transferred to recipients, two of which gave birth to a total of 11 piglets. Of those 11 piglets, 9 survived. Molecular genetic analysis confirmed that 6 of 9 live piglets carried mutations in TP53, including 2 piglets with no wild-type (WT) sequences and 4 genetically mosaic piglets with WT sequences. One mosaic piglet had 142 and 151 bp deletions caused by a combination of the two sgRNAs. These piglets were continually monitored for 16 months and three of the genome-edited pigs (50%) exhibited various tumor phenotypes that we presumed were caused by TP53 mutations. Two mutant pigs with no WT sequences developed mandibular osteosarcoma and nephroblastoma. The mosaic pig with a deletion between targeting sites of two sgRNAs exhibited malignant fibrous histiocytoma. Tumor phenotypes of TP53 mosaic mutant pigs have not been previously reported. Our results indicated that the mutations caused by gene editing successfully induced tumor phenotypes in both TP53 mosaic- and bi-allelic mutant pigs.

Associated conditions in patients with multiple dermatofibromas: Case reports and literature review.

Dermatofibromas are benign, fibrohistiocytic, dermal tumors. Solitary dermatofibromas may be incidental findings, whereas multiple dermatofibromas may be associated with systemic conditions or previous therapies. Two women and one man with multiple dermatofibromas and an associated systemic condition, immunosuppression, or both, are described. Nine dermatofibromas developed in a woman with hypothyroidism, optic neuritis, and Arnold Chiari I malformation. Five dermatofibromas developed in a woman with breast cancer who had received several systemic antineoplastic therapies. Eleven dermatofibromas developed in a man with HIV whose systemic therapies included acyclovir, darunavir/cobicistat, dolutegravir, etravirine, and ritonavir. Conditions associated with multiple dermatofibromas include autoimmune diseases, cancer, chromosomal abnormalities, immunodeficiencies, metabolic disturbances, and altered physiologic states such as pregnancy. Medications received by patients with multiple dermatofibromas included immunosuppressive agents, psoriasis therapies, and antineoplastic drugs. Multiple dermatofibromas can be observed in patients with associated medical conditions, systemic therapies, or both. Therefore, in individuals presenting with multiple dermatofibromas, not only evaluation for associated disorders, but also review of prior and current drug therapies, should be considered.

¿Histiocitosis pulmonar? o ¿tuberculosis pulmonar? en un paciente con infiltración histiocitaria cutánea / No disponible

Se presenta un caso de una paciente de 62 años, remitida desde Dermatología a nuestra consulta por presentar una lesión pápulo-nodular infiltrada eritematosa en mejilla izquierda con resultado en la biopsia de una infiltración dérmica y de tejido celular subcutáneo por histiocitos y ocasionales células gigantes multinucleadas con material microvacuolar. En la TC torácica para estudio de extensión aparecen infiltrados parenquimatosos sospechoso de histiocitosis pulmonar. Informándose en el estudio microbiológico del BAS como tinción de Ziehl-Nielsen positiva

A case of a female patient aged 62, sent from Dermatology to our office due infiltrated erythematous papule-nodular lesion in the left cheek with biopsy results in a dermal infiltration and subcutaneous tissue histiocytes and occasional giant cells were present with microvacuolar material. In the thoracic CT for suspected parenchymal extension study of pulmonary histiocytosis appear infiltrates. Micribiologico informing the study of BAS as Ziehl-Nielsen positive

Dermatofibroma in a black tattoo: report of a case.

Tattooing has been associated with a variety of complications including inflammatory and granulomatous reactions, transmission of infections, and neoplasms. We report a case of a 24-year-old male who presented with a 2-month history of an erythematous nodule involving a newly made tattoo on the right leg. An excisional biopsy was performed and the histopathological evaluation was consistent with dermatofibroma. Only three cases of dermatofibroma associated with tatooing were reported in literature. We report an additional case and review the literature regarding cutaneous reactions to tattoos.

Dermatofibroma in a black tattoo: report of a case / Dermatofibroma sob pigmento preto de tatuagem: relato de um caso

Tattooing has been associated with a variety of complications including inflammatory and granulomatous reactions, transmission of infections, and neoplasms. We report a case of a 24-year-old male who presented with a 2-month history of an erythematous nodule involving a newly made tattoo on the right leg. An excisional biopsy was performed and the histopathological evaluation was consistent with dermatofibroma. Only three cases of dermatofibroma associated with tatooing were reported in litetature. We report an additional case and review the literature regarding cutaneous reactions to tattoos.

Tatuagens têm sido associadas com uma variedade de complicações incluindo reações inflamatórias e granulomatosas, transmissão de infecções e neoplasias. Relatamos um caso de homem com 24 anos de idade que apresentava há dois meses nódulo eritematoso sob pigmento preto de uma tatuagem na coxa direita. A biópsia excisional foi realizada e a avaliação histológica foi consistente com dermatofibroma. Apenas três casos da associação dermatofibroma e tatuagem foram relatados na literatura. Nós reportamos um caso adicional e revisamos a literatura sobre reações cutâneas em tatuagens.

The involvement of fibroblast growth factor receptor signaling pathways in dermatofibroma and dermatofibrosarcoma protuberans.

Fibroblast growth factors (FGFs) and their receptors (FGFRs) control a wide range of biological functions; however, their involvement in the pathogenesis of dermatofibroma (DF) and dermatofibrosarcoma protuberans (DFSP) is currently unknown. In this study, we first confirmed the histological diagnosis by detecting fusion COL1A1-PDGFB transcripts in DFSP, and examined the expression of all FGFRs (FGFR1-4), some of their ligands (FGF1, 2, 9), and forkhead box N1 (FOXN1) as a downstream target of FGFR3 in DF and DFSP by immunohistochemical analysis. Although we failed to detect the expression of FGF1 and FGF9 as specific ligands for FGFR3 in DF, overexpression of FGFR3 and FOXN1 was observed in the epidermal regions of DF, suggesting that the epidermal regions of DF were similar to seborrhoeic keratosis both in terms of histological features and the activation of FGFR3/FOXN1. In addition, strong expression of FGF2 and FGFR4 was observed in the tumor lesions of DF. Expression patterns of FGFR3/FOXN1 and FGF2/FGFR4 in DF were in contrast with those of DFSP. The activation of FGFR signaling pathways may be not only relevant to the pathogenesis of DF, but also very useful in the differential diagnosis of DF and DFSP.

Uncommon cutaneous neoplasms of the head and neck.

This article concentrates on the less-common cutaneous malignancies such as merkel cell, atypical fibroxanthoma, malignant fibrous histiocytoma, dermatofibrosarcoma protuberans, microcystic adnexal carcinoma, and sebaceous carcinoma. The clinical and histopathologic descriptions of each, most current and emerging etiologies, diagnosis, staging, treatment, and prognosis are discussed.

Case report: Bone tumor of the scapula in a patient undergoing liver transplantation.

BACKGROUND: De novo malignancies are serious complications in the late postoperative period after liver transplantation. The most common de novo tumors are skin malignancies, posttransplantation lymphoproliferative disorder, tumors of the head and neck, and Kaposi's sarcoma. Such posttransplant de novo malignancies are apparently rarely found in bone. CASE DESCRIPTION: We describe a patient with a low-grade, aggressive fibrous histiocytoma of the scapula. The patient had undergone liver transplantation 6 years earlier. En bloc resection of the tumor and limb salvage was performed. At the 2-year followup the patient had no signs of local recurrence or metastatic spread; the patient had a Musculoskeletal Tumor Society (MSTS) score of 87. LITERATURE REVIEW: A literature review suggests the main predisposing factors to such malignancies are immunosuppression and its length of use. According to the literature, tumors apparently are rare in bone after liver transplantation, with no clearly documented cases. However, in the presence of such a finding, our study might be the first clearly documented case study of this kind of bone tumor. CLINICAL RELEVANCE: We describe a patient with a bone tumor after liver transplantation. Our literature review suggests liver transplantation and long-term immunosuppression played a role in this patient's tumor.

Clinical spectrum of atypical fibroxanthoma and undifferentiated pleomorphic sarcoma in solid organ transplant recipients: a collective experience.

BACKGROUND: Atypical fibroxanthoma (AFX) and undifferentiated pleomorphic sarcoma (UPS) are uncommon, spindle cell cutaneous malignancies. Solid organ transplant recipients (SOTRs) are immunosuppressed and therefore have a higher incidence of cutaneous malignancies. OBJECTIVE: We describe the clinical spectrum of AFX and a more-aggressive, deeper variant, UPS, in SOTRs. MATERIALS AND METHODS: A retrospective chart review of AFX and UPS in SOTRs was implemented. Cases from Vanderbilt University, Emory University, Mayo Clinic-Jacksonville, and University of Rochester were included. A literature search included previously published cases. RESULTS: The average age of SOTRs at time of tumor presentation was younger than typically seen in immunocompetent patients for AFX. Rates of local recurrences and metastases were higher in the SOTRs than is noted in the immunocompetent literature. Rates of recurrence were higher in those treated with excision than in those treated with Mohs micrographic surgery (MMS). CONCLUSION: AFX and UPS may have a greater risk for recurrence, metastases, and mortality in SOTRs, in whom early treatment with MMS may demonstrate certain advantages in terms of minimizing risk of recurrence and metastasis. UPS and recurrent tumors should be staged appropriately and may respond to adjuvant radiation therapy and reduction of immunosuppression. Immunohistochemical evaluation is recommended to exclude other spindle cell tumors.

Atypical fibroxanthoma of the scalp following hair transplantation in a 35-year-old male.

Atypical fibroxanthoma (AFX) is an uncommon spindle cell neoplasm of the elderly. This case report presents an atypical case of AFX of the scalp 8 years after hair transplantation in a 35-year-old male patient. Possible synergistic effects of previous sun exposure radiation to the scalp, together with the thermal and radiation injury of carbon dioxide (CO(2)) laser, might explain the mechanisms of the development of AFX at such an early age. To the best of our knowledge, this case report is the first description in the medical literature of development of skin malignancy on a hair-transplanted scalp.