Sarcomatoid Carcinoma With Quasi-Complete Loss of Cytokeratin Expression or Keratin-Positive Atypical Fibroxanthoma.

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  • Author(s): Roy SF;Roy SF; Lafaille P; Lafaille P; Désy D; Désy D
  • Source:
    International journal of surgical pathology [Int J Surg Pathol] 2019 Aug; Vol. 27 (5), pp. 518-520. Date of Electronic Publication: 2019 Feb 14.
  • Publication Type:
    Case Reports; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Sage Publications Country of Publication: United States NLM ID: 9314927 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1940-2465 (Electronic) Linking ISSN: 10668969 NLM ISO Abbreviation: Int J Surg Pathol Subsets: MEDLINE
    • Publication Information:
      Publication: Thousand Oaks, CA : Sage Publications
      Original Publication: Naperville, IL : Churchill Livingstone, c1993-
    • Subject Terms:
      Biomarkers, Tumor/*analysis ; Carcinoma/*diagnosis ; Keratins/*analysis ; Skin/*pathology ; Skin Neoplasms/*diagnosis; Aged, 80 and over ; Biomarkers, Tumor/metabolism ; Carcinoma/pathology ; Carcinoma/surgery ; Diagnosis, Differential ; Face ; Hemangiosarcoma/diagnosis ; Hemangiosarcoma/pathology ; Humans ; Keratins/metabolism ; Leiomyosarcoma/diagnosis ; Leiomyosarcoma/pathology ; Male ; Melanoma/diagnosis ; Melanoma/pathology ; Mohs Surgery ; Skin Neoplasms/pathology ; Skin Neoplasms/surgery
    • Abstract:
      We report the case of a 94-year-old man with a rapidly growing nodule on the preauricular area, which on histology showed a poorly differentiated spindle cell tumor with negative p63 and p40 antibody immunostains, negative high- and low-molecular-weight cytokeratins albeit for a focal expression of cytokeratin AE1/AE3. Spindle cell melanoma, angiosarcoma, and leiomyosarcoma were excluded. We explore the diagnostic approach to this challenging conundrum. Certain authors have suggested that sarcomatoid carcinoma and atypical fibroxanthoma (AFX) may lie within a spectrum of "sarcoma-like tumors of the head and neck" and that they may all run a similarly indolent clinical course. However, AFX appears to remain a diagnosis of exclusion, and expert consensus is that by definition AFX cannot express any cytokeratin antigens.
    • Contributed Indexing:
      Keywords: atypical fibroxanthoma; dermatopathology; keratin-positive atypical fibroxanthoma; pleomorphic dermal sarcoma; sarcomatoid carcinoma; spindle cell squamous cell carcinoma
    • Accession Number:
      0 (Biomarkers, Tumor)
      68238-35-7 (Keratins)
    • Publication Date:
      Date Created: 20190215 Date Completed: 20191223 Latest Revision: 20191223
    • Publication Date:
      20240829
    • Accession Number:
      10.1177/1066896919830208
    • Accession Number:
      30760056