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Spontaneous Involution (regression) Of A Solitary Cutaneous Myofibroma In An Adult Patient

Heath, M., Hajar, T., Korcheva, V., & Leitenberger, J. (2018). Spontaneous involution (regression) of a solitary cutaneous myofibroma in an adult patient. Journal of cutaneous pathology, 45(2), 159–161. https://doi.org/10.1111/cup.13071

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Abstract

Myofibromas are unusual benign tumors most commonly seen in infant children. Clinical involution of the tumor often occurs within the first few years of life. Solitary cutaneous myofibroma is the synonymous adult counterpart of infantile myofibromatosis. Although solitary myofibromas have been reported in patients of all ages, only the infantile variant is believed to regress spontaneously. There are only a few case reports of adolescent and young adult patients with regressing solitary lesions that have been described in the literature to date. We report a 71-year-old male with spontaneous regression of solitary cutaneous myofibroma. The residual lesion was excised and to date has not recurred. This report describes the historical, clinical and histopathological features of adult myofibromas and a novel manifestation that may guide future clinical considerations when approaching solitary tumors with regressive features.

Case Details

Disease Location

Skin

Personal Characteristics

71-year-old caucasian male. History of non-melanoma skin cancer

Clinical Characteristics

Presented with a well-demarcated 2 cm violaceous, firm, and mobile plaque surrounded by a violaceous patch located on the right lower eyelid. The lesion developed over a period of 5 months. 2.5 months after his initial clinic evaluation, examination was remarkable only for a subtle, well-demarcated, flat-topped, 5 mm erythematous papule on the lower eyelid. The lesion was then excised and submitted for histological evaluation. Microscopic examination revealed a few small, well-circumscribed nodules composed of spindled cells with relatively uniform nuclei and eosinophilic cytoplasm, forming whorls. There was surrounding fibrosis and a superficial and deep perivascular and interstitial inflammatory infiltrate, composed of lymphocytes. The spindled cells were positive for smooth muscle actin (sma). These findings are consistent with solitary cutaneous myofibroma of adulthood

Remission Characteristics

The presence of surrounding dermal fibrosis and inflammation in combination with the clinical presentation suggest spontaneous involution (regression)

Treatment & Mechanisms

Clinical Treatment

Biopsy