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["Dangerous" cutaneous polyp. Exophytic cutaneous myxofibrosarcoma].

B E Paredes1, T Mentzel, R Denfeld

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Summary

Unusual large skin tag presentations can mask malignant skin tumors like myxofibrosarcoma (MFS). Early recognition and thorough investigation of atypical lesions are crucial for timely diagnosis and treatment of this common adult sarcoma.

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Area of Science:

  • Dermatopathology
  • Surgical Oncology
  • Medical Oncology

Background:

  • Malignant skin tumors rarely present as polypoid lesions.
  • Large skin tag-like presentations can obscure malignancy.
  • Myxofibrosarcoma (MFS) is a common sarcoma in adults, but rarely appears as a skin tag.

Observation:

  • A case is presented where a lesion clinically resembling a large skin tag was diagnosed as myxofibrosarcoma (MFS).
  • The protuberant nature of the lesion led to initial misdiagnosis and shave biopsy.
  • The rapid growth of the polypoid sarcoma prompted further investigation.

Findings:

  • Myxofibrosarcoma (MFS), also known as myxoid malignant fibrous histiocytoma, is a common adult sarcoma.
  • Clinical presentation as a large skin tag is an extremely rare manifestation of MFS.
  • Histologically, MFS is characterized by a multinodular structure, mucinous stroma, and curvilinear fine vessels.

Implications:

  • Unusual clinical presentations of common lesions warrant thorough investigation.
  • Prompt surgical removal is indicated for rapidly growing polypoid sarcomas.
  • The behavior and metastatic potential of MFS depend on tumor grade, size, depth, and local control.