Pleomorphic Onychomatricoma: A Mimicker of Malignancy
DOI:
https://doi.org/10.2340/actadv.v101.546Keywords:
onychomatricoma, pleomorphic onychomatricoma, superficial CD34-positive fibroblastic tumour, superficial acral fibromyxoma, nail tumour, subungual squamous cell carcinomaAbstract
Pleomorphic onychomatricoma is a rare condition mimicking malignant neoplasms. Given its rarity, the diagnostic and prognostic criteria of this condition are not well established. The aim of this study was to characterize a series of 6 cases of pleomorphic onychomatricoma. In 3 cases the submitting clinical diagnosis was subungual squamous cell carcinoma. For all 6 cases, nail clipping showed typical features of onychomatricoma as a free-edge thickening and pitting of the nail plate with an additional feature of projecting line pattern. Pleomorphic onychomatricoma was diagnosed based on moderate–severe cytological atypia, yet degenerative-appearing with multinucleation or smudged chromatin, no mitotic activity or necrosis, and a Ki67 proliferative index inferior to 5% overall. Other finding s included epithelioid multinucleated cells with deeply eosinophilic cytoplasm mimicking epithelioid malignant cells, overexpression of Ki67 and p53 on atypical cells and diffuse expression of p16. This study describes additional criteria in pleomorphic onychomatricoma, permitting a wider recognition in order to avoid inappropriate treatment.
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Ko CJ, Shi L, Barr RJ, Mölne L, Ternesten-Bratel A, Headington JT. Unguioblastoma and unguioblastic fibroma - an expanded spectrum of onychomatricoma. J Cutan Pathol 2004; 31: 307-311.
https://doi.org/10.1111/j.0303-6987.2004.0151.x DOI: https://doi.org/10.1111/j.0303-6987.2004.0151.x
Perrin C, Baran R, Balaguer T, Chignon-Sicard B, Cannata GE, Petrella T, et al. Onychomatricoma: new clinical and histological features. A review of 19 tumors. Am J Dermatopathol 2010; 32: 1-8.
https://doi.org/10.1097/DAD.0b013e3181af8516 DOI: https://doi.org/10.1097/DAD.0b013e3181af8516
Petersson F, Tang ALY, Jin ACE, Barr RJ, Lee VK. Atypical cellular unguioblastic fibroma. A rare case with more atypical histological features than previously reported. Am J Dermatopathol 2010; 32: 387-391.
https://doi.org/10.1097/DAD.0b013e3181c03402 DOI: https://doi.org/10.1097/DAD.0b013e3181c03402
Fernandez-Flores A, Barja-Lopez JM. Pleomorphic onychomatricoma. J Cutan Pathol 2014; 41: 555-560.
https://doi.org/10.1111/cup.12363 DOI: https://doi.org/10.1111/cup.12363
Hassanein A, Telang G, Benedetto E, Spielvogel E. Subungual myxoid pleomorphic fibroma. Am J Dermatopathol 1998; 20: 502-505.
https://doi.org/10.1097/00000372-199810000-00015 DOI: https://doi.org/10.1097/00000372-199810000-00015
Hsieh YJ, Lin YC, Wu YH, Su HY, Billings ST, Hood AF. Subungual pleomorphic fibroma. J Cutan Pathol 2003; 30: 569-571.
https://doi.org/10.1034/j.1600-0560.2003.00105.x DOI: https://doi.org/10.1034/j.1600-0560.2003.00105.x
Perrin C Pedeutour F, Dadone-Montaudié B, Ambrosetti D. Superficial CD34-positive fibroblastic tumor: case report of an unique subungual presentation with confounding clinical findings resembling fibrokeratoma-like Bowen's disease. Acta Derm Venereol 2021; 101: adv00388.
https://doi.org/10.2340/00015555-3727 DOI: https://doi.org/10.2340/00015555-3727
Di Chiacco N, Tavares GT, Tosti A, Di Chiacco NG, Di Santis E, Alvarenga L, et al. Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases. Br J Dermatol 2015; 173: 1305-1307.
https://doi.org/10.1111/bjd.13900 DOI: https://doi.org/10.1111/bjd.13900
Lesort C, Debarbieux S, Duru G, Dalle S, Poulhalon N, Thomas L. Dermatoscopic features of onychomatricoma: a study of 34 cases. Dermatology (Basel) 2015; 231: 177-183.
https://doi.org/10.1159/000431315 DOI: https://doi.org/10.1159/000431315
Teysseire S, Dalle S, Duru G, Phan A, Debarbieux S, Poulhalon N, et al. Dermatoscopic features of subungual squamous cell carcinoma: a study of 44 cases. Dermatology (Basel) 2017; 233: 184-191.
https://doi.org/10.1159/000479059 DOI: https://doi.org/10.1159/000479059
Perrin C, Cannata GE, Langbein L, Ambrosetti D, Coutts M, Balaguer T, et al. Acquired localized longitudinal pachyonychia and onychomatrical tumors: a comparative study to onychomatricomas (five cases) and onychocytic matricomas (four cases). Am J Dermatopathology 2016; 38: 664-671.
https://doi.org/10.1097/DAD.0000000000000511 DOI: https://doi.org/10.1097/DAD.0000000000000511
Perrin C. Onychomatricoma micropapilliferum, a new variant of onychomatricoma: clinical, dermoscopical and histological correlation; (report of 4 cases). Am J Dermatopathol 2020; 42: 103-110.
https://doi.org/10.1097/DAD.0000000000001440 DOI: https://doi.org/10.1097/DAD.0000000000001440
Perrin C, Ambrosetti D, Balme B, Thomas L. Clinical, dermoscopical, and pathologic feature of onychomatricoma new variant ressembling onycholemmal/squamous cell carcinoma. Am J Dermatopathol 2020; 42: 827-834.
https://doi.org/10.1097/DAD.0000000000001648 DOI: https://doi.org/10.1097/DAD.0000000000001648
Hollmann TJ, Bovée JV, Fletcher CD. Digital fibromyxoma (superficial acral fibromyxoma): a detailed characterization of 124 cases. Am J Surg Pathol 2012; 36: 789-798.
https://doi.org/10.1097/PAS.0b013e31824a0b83 DOI: https://doi.org/10.1097/PAS.0b013e31824a0b83
Perrin C, Cannata GE, Pedeutour F, Dadone-Montaudié B, Ambrosetti D. Cellular angiofibroma: a case report of a unique subungual presentation. Acta Derm Venereol 2019; 19: 915-916.
https://doi.org/10.2340/00015555-3152 DOI: https://doi.org/10.2340/00015555-3152
Dermawan JK, Azzato EM, Golblum JR, Rubin BP, Billings SD, KO JS. Superficial ALK-rearranged myxoid spindle cell neoplasm: a cutaneous soft tissue tumor with distinctive morphology and immunophenotypic profile. Modern Pathol 2021; 34: 1710-1718.
https://doi.org/10.1038/s41379-021-00830-w DOI: https://doi.org/10.1038/s41379-021-00830-w
Perret R, Michal M, Carr RA,Velasco V, Svajdler M, Karanian M, et al. Superficial CD34-positive fibroblastic tumor and PRDM10-rearranged soft tissue tumor are overlapping entities: a comprehensive study of 20 cases. Histopathology 2021; 79: 810-825.
https://doi.org/10.1111/his.14429 DOI: https://doi.org/10.1111/his.14429
Mosquera JM, Fletcher CD. Expanding the spectrum of malignant progression in solitary fibrous tumors. Am J Surg Pathol 2009; 33: 1314-1321.
https://doi.org/10.1097/PAS.0b013e3181a6cd33 DOI: https://doi.org/10.1097/PAS.0b013e3181a6cd33
Shah KK, Mc Hugh JB, Folpe AL Patel RM. Dermatofibrosarcoma protuberans of distal extremities and acral sites. A clinicopathologic analysis of 27 cases. Am J Surg Pathol 2018; 42: 413-419.
https://doi.org/10.1097/PAS.0000000000000998 DOI: https://doi.org/10.1097/PAS.0000000000000998
Suster S, Fisher C, Moran CA. Expression of bcl2 oncoprotein in benign and malignant spindle cell tumor of soft tissue, skin, serosal surface and gastrointestinal tract. Am J Surg Pathol 1998; 22: 863-872.
https://doi.org/10.1097/00000478-199807000-00008 DOI: https://doi.org/10.1097/00000478-199807000-00008
Hinds B, Pérez ADA, LeBoitPE, Mc Calmont TH, North JP. Loss of retinoblastoma in pleomorphic fibroma: an immunohistochemical and genomic analysis. J Cutan Pathol 2017; 44: 665-671.
https://doi.org/10.1111/cup.12965 DOI: https://doi.org/10.1111/cup.12965
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