A nodular lesion of the toe

Acral fibromyxoma: a rare plantar nodule

Acral fibromyxomas are benign tumours ranging in size between 0.6 and 5 cm, commonly found around the nailbed. The often asymptomatic presentation of acral fibromyxomas means that there is often a delay in their diagnosis and subsequent treatment. The objective of this paper is to present the unique case of a fibromyxoma present in the acral region, as well as a review of the literature.

Superficial Acral Fibromyxoma: Literature Review

Superficial acral fibromyxoma is a benign and rare tumor of the soft tissues. It usually manifests itself through a painless mass of slow growth that affects mainly males in the fifth decade of life. It usually affects the distal region, with a polypoid or dome-shaped appearance. The histological appearance is of a dermal mass without capsule, with spindle-shaped fibroblasts in a storiform or fasciculated pattern in the myxocollagenous stroma. The immunohistochemical evaluation of superficial acral fibromyxoma is usually positive for CD34 and CD99, with variable positivity for epithelial membrane antigen. The treatment consists of complete excision of the tumor mass.

A review of the current literature on superficial acral fibromyxoma was performed, with an emphasis on the number of cases reported, location, diagnostic methods, histological characteristics, differential diagnoses and treatment.

A total of 314 reported cases of superficial acral fibromyxoma with variable locations were found in the current literature, mainly in the toes (45.8%) and fingers (39.1%). It has a slightly superior incidence in men (61%) and enormous variability in the age range of occurrence.

Superficial acral fibromyxoma is a single soft-tissue tumor that should enter the differential diagnosis of periungual and subungual acral lesions; the treatment consists of simple excision. More studies are needed to better understand this pathology, which was first described in 2001.

Superficial Acral Fibromyxoma of the Toe: Unusual Location of the Mixoid Variant

Superficial acral fibromyxoma (SAFM) is a rare soft tissue tumor that frequently involves the periungual and subungual regions of acral surfaces. Macroscopically, it appears as a flesh-colored dome-shaped solitary mass; microscopically, it consists of a moderately cellular proliferation of spindle-shaped fibroblast-like cells embedded in a myxocollagenous stroma and arranged in a loose storiform and focally fascicular pattern. The tumor cells are immunoreactive for CD34, epithelial membrane antigen, CD99, and CD10. In this study, we describe a case of SAFM on the fourth toe with predominantly myxoid stroma. Our case, in contrast of those reported in the literature, showed an unusual location for the myxoid variant. SAFM is often not recognized; it may resemble some benign and malignant mesenchymal neoplasm. The gold standard treatment is surgery. The tumor was completely excised, and no recurrence was evident at 1-year follow-up. Awareness of this entity facilitates its diagnosis and management, avoiding unwarranted concerns and additional procedures for the patient.

Superficial acral fibromyxoma

Superficial acral fibromyxoma (SAF), also known as digital fibromyxoma, is a rare soft tissue tumor with a predilection for acral surfaces. Superficial acral fibromyxoma classically presents as a pink to flesh-colored nodule located on the subungual or periungual region of the hands or feet. It is typically slow-growing and asymptomatic, which, coupled with its nonspecific clinical appearance, presents a diagnostic dilemma to the dermatologist. As these features overlap with those of a multitude of differential diagnoses, it is imperative to have a good understanding of the characteristics on which the diagnosis of SAF is based. Superficial acral fibromyxoma was initially described in 2001, since when several case reports and literature reviews have contributed to our current understanding of these tumors. In this article, we will review the history, clinical features, diagnosis, and management of SAF. It is our hope that this systematic approach will help to facilitate the recognition and management of this distinct dermatologic entity.