Dermatofibromas on the Foot and Ankle: A Clinicopathologic Characterization of 31 Cases.

IF 0.5 4区 医学 Q4 ORTHOPEDICS
Xingpei Hao, David Freedman, Joon Yim, Michelle Le, Robert Baglio, David Levine, Gina Saffo, Priya Parthasarathy, Gene Mirkin
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Abstract

Background: Dermatofibroma (DF) is a common benign soft-tissue tumor. It occurs anywhere on the body but is commonly seen on the upper and lower extremities. It is frequently found in young to middle-aged adults and predominantly in females.

Methods: Thirty-one patients with DF on the foot and ankle diagnosed and treated during a 6-year period were characterized.

Results: The patients (16 males, 15 females) were aged 7 to 75 years (average, 55 years). Clinically, 17 patients noted painful symptoms, and 14 were painless. Grossly, DF manifested as a raised red, pink, tan, or skin-colored soft mass. The tumor size ranged from 0.3 to 1.5 cm (average, 0.67 cm in diameter). Twenty-six DFs (84%) were localized on the dorsal surface of the foot and ankle, and five (16%) were found on the plantar aspect. Eighteen patients were treated by surgical excision of the tumor (>0.5 cm), and 13 patients had observational follow-up after punch biopsy due to the small size (≤0.5 cm) and benign nature of these lesions. Further follow-up found that only one patient (3.2%) had a local recurrence, 37 months after surgical excision, which was completely reexcised. Histologically, DF is characterized by proliferation of spindle fibroblasts and histiocytes, in a vague fascicular pattern, and thickened collagen bundles.

Conclusions: Dermatofibroma on the foot and ankle predominantly occurs in patients in their 50s, without a preponderance by sex. It needs to be differentiated from other benign and malignant tumors with histologic analysis and immunostaining with factor XIIIa, CD68, and other biomarkers. Treatment options include either surgical excision or observational follow-up after biopsy, depending on the clinical characteristics and effect on functional activity.

足踝皮纤维瘤:31 个病例的临床病理特征。
背景:皮纤维瘤(DF)是一种常见的良性软组织肿瘤。它发生在身体的任何部位,但常见于上肢和下肢。常发于中青年,女性居多:方法:对 6 年间诊断和治疗的 31 例足踝 DF 患者进行特征描述:患者(16 名男性,15 名女性)的年龄在 7 至 75 岁之间(平均 55 岁)。临床上,17 名患者有疼痛症状,14 名患者无疼痛症状。大体上,DF表现为隆起的红色、粉红色、棕褐色或皮肤色的软肿块。肿瘤大小从 0.3 厘米到 1.5 厘米不等(平均直径为 0.67 厘米)。26 个 DF(84%)位于足部和踝关节的背侧,5 个(16%)位于足跖侧。18名患者通过手术切除了肿瘤(>0.5厘米),13名患者由于肿瘤较小(≤0.5厘米)且为良性病变,在打孔活检后进行了观察随访。进一步的随访发现,只有一名患者(3.2%)在手术切除 37 个月后局部复发,并完全切除。组织学上,DF的特征是纺锤形成纤维细胞和组织细胞增生,呈模糊的束状,胶原束增厚:结论:足部和踝部的皮纤维瘤主要发生在 50 多岁的患者身上,与性别无关。需要通过组织学分析和 XIIIa 因子、CD68 及其他生物标记物的免疫染色来将其与其他良性和恶性肿瘤区分开来。治疗方法包括手术切除或活检后观察随访,具体取决于临床特征和对功能活动的影响。
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来源期刊
CiteScore
1.10
自引率
0.00%
发文量
128
审稿时长
6-12 weeks
期刊介绍: The Journal of the American Podiatric Medical Association, the official journal of the Association, is the oldest and most frequently cited peer-reviewed journal in the profession of foot and ankle medicine. Founded in 1907 and appearing 6 times per year, it publishes research studies, case reports, literature reviews, special communications, clinical correspondence, letters to the editor, book reviews, and various other types of submissions. The Journal is included in major indexing and abstracting services for biomedical literature.
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