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Ossifying Plexiform Tumor: Report of Two New Cases

Walsh, Sarah N MD; Sangüeza, Omar P MD

The American Journal of Dermatopathology: February 2008 - Volume 30 - Issue 1 - p 73-76
doi: 10.1097/DAD.0b013e31815f656a
Extraordinary Case Report

Ossifying plexiform tumor is a cutaneous lesion that microscopically resembles cellular neurothekeoma but has abundant central ossification as the prominent feature and has only been previously described in a single case report. We detail 2 additional examples, both arising on the finger of adult women (36 and 76 years old). Clinically, the lesions were described as a raised flesh-colored “extraosseous” mass, averaging 1.1 cm in greatest dimension. Histological examination showed an unencapsulated well-delineated dermal tumor with thin fibrous bands separating lobules and fascicles of epithelioid to spindled cells that were embedded in a somewhat loose myxoid matrix. Present within the center of the lobules were large irregular foci of mature bone, some lined by osteoblasts. After excision, these lesions have not recurred or persisted in a limited follow-up duration (9 and 2 months). In concordance with the only other case report of a 30-year-old woman with a left thumb mass, ossifying plexiform tumor has occurred exclusively on the digits of adult women. Although it is possible that ossifying plexiform tumor could represent an ossifying variant of cellular neurothekeoma, we believe it is a lesion sui generis, and hope its recognition will allow for an accurate diagnosis and distinction from other cutaneous ossifying lesions.

From the Wake Forest University School of Medicine, Winston-Salem, NC.

Reprints: Sarah N. Walsh, MD, Wake Forest University School Medicine, Medical Center Boulevard, Winston-Salem, NC 27157 (e-mail: sarahnwalsh@aol.com).

© 2008 Lippincott Williams & Wilkins, Inc.