Superficial acral fibromyxoma

Superficial acral fibromyxoma is a rare, benign tumor that primarily affects the skin and soft tissues of the hands and feet. It was first described in 2001 by Fetsch et al., and since then, over 100 cases have been reported worldwide.

Epidemiology

Superficial acral fibromyxoma typically affects adults between the ages of 40 and 70, with a slight male predominance. It is extremely rare in children. The exact incidence and prevalence of this condition are unknown due to its rarity.

Pathogenesis

The pathogenesis of superficial acral fibromyxoma is not well understood. It is believed to originate from the fibroblasts or myofibroblasts in the superficial dermis or subcutaneous tissue. Some studies suggest a possible association with trauma or chronic irritation, but this has not been definitively proven.

Clinical Presentation

Patients with superficial acral fibromyxoma usually present with a slow-growing, painless mass on the fingers or toes. The mass is typically firm and well-circumscribed, and can range in size from a few millimeters to several centimeters. Skin overlying the mass may appear normal or may show changes such as discoloration or ulceration.

Diagnosis

Diagnosis of superficial acral fibromyxoma is primarily based on histopathological examination of the tumor. Immunohistochemistry studies are often helpful in confirming the diagnosis. Imaging studies such as MRI or ultrasound may be used to assess the extent of the tumor and to plan for surgical removal.

Treatment

The mainstay of treatment for superficial acral fibromyxoma is surgical excision of the tumor. Due to the risk of local recurrence, wide excision with clear margins is recommended. In cases where surgery is not feasible or the tumor is recurrent, other treatment options such as radiotherapy or chemotherapy may be considered.

Prognosis

The prognosis for patients with superficial acral fibromyxoma is generally good. The tumor is benign and does not metastasize. However, there is a risk of local recurrence, particularly if the tumor is not completely removed.