Sir, We report a 17 year-old woman who presented with a 1-year history of left axillary palpable mass. At physical examination the lesion was firm, lipomatous. The breast ultrasonography showed a left voluminous axillary mass, measuring 54mm, hyperechoic and ill limited. A surgical resection of the mass was performed. Grossly, it was a white firm well-circumscribed and lobed mass measuring 15x10x6 cm. Histological examination showed a benign mesenchymal tumor. It consisted of abundant fibrosis with hyalinised vessels, containing mononuclear infiltrate and foci of psammomatous calcifications (<xref ref-type="fig" rid="F1">Fig. 1</xref>). Lymphoid follicles were noted around vessels and psammomas (<xref ref-type="fig" rid="F2">Fig. 2</xref>). The tumor did not show any features of malignancy. Immunohistochemically, the spindle cells were vimentin positive (<xref ref-type="fig" rid="F3">Fig. 3</xref>) and vessels showed CD34 positivity. These features confirmed the diagnosis of Calcifying fibrous tumors. At 4 years of follow-up, the patient was asymptomatic and there was no recurrence. <fig id="F1"> <label>Figure 1</label> <caption> Tumor composed of abundant fibrosis with hyalinised vessels, containing mononuclear infiltrate and foci of psammomatous calcifications. </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-487-g001.tif"/> </fig> <fig id="F2"> <label>Figure 2</label> <caption> Lymphoid follicles were noted around vessels and psammomas. </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-487-g002.tif"/> </fig> <fig id="F3"> <label>Figure 3</label> <caption> Spindle cells showing strong expression of vimentin. </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-487-g003.tif"/> </fig> The patient’s informed consent was obtained. Prior to the study, patient gave written consent to the examination and biopsy after having been informed about the procedure. Calcifying fibrous tumor (CFT) is a rare, usually solitary, benign tumor of uncertain etiology. The most common sites are the soft tissues of the extremities, pleura, or peritoneum [<xref ref-type="bibr" rid="ref1">1</xref>]. It usually affects children and young adults, and it is composed of hyalinized fibrous tissue with dispersed bland fibroblastic spindled cells, scattered psammomatous, and/or dystrophic calcifications, and variably prominent mononuclear inflammatory infiltrate [<xref ref-type="bibr" rid="ref2">2</xref>]. Macroscopically, CFT is well circumscribed and unencapsulated. Its diameter ranges from 1 to 15 cm. Their etiopathogenesis has not been fully clarified yet. However, in the literature, there are cases that may be related to trauma and Castleman’s disease [<xref ref-type="bibr" rid="ref3">3</xref>]. Resection of CFT is usually curative. Local recurrence rate is approximately 10% [<xref ref-type="bibr" rid="ref1">1</xref>]. <sec id="sec2-1"> <title>Consent

Our Dermatol Online

2081-9390

Our Dermatology Online

Poland

OURD-7-487

10.7241/ourd.20164.134

Letter to the Editor

Calcifying fibrous tumor of axillary region

Hadj

Olfa El Amine El

1 Bouhajja

Leila

1 Goucha

Aida

1 Hassouna

Jameleddine Ben

2 May

Ahmed El

1 Gamoudi

Amor

1Department of Pathology, Carcinological Institute Salah Azaiez, Tunis, Tunisia 2Department of Carcinological Surgery, Carcinological Institute Salah Azaiez, Tunis, Tunisia

Corresponding author: Dr. Olfa El Amine El Hadj, E-mail: olfaelamine@yahoo.fr

2016

7 4 487 488 05032016 25042016

2016

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Sir, We report a 17 year-old woman who presented with a 1-year history of left axillary palpable mass. At physical examination the lesion was firm, lipomatous. The breast ultrasonography showed a left voluminous axillary mass, measuring 54mm, hyperechoic and ill limited. A surgical resection of the mass was performed. Grossly, it was a white firm well-circumscribed and lobed mass measuring 15x10x6 cm. Histological examination showed a benign mesenchymal tumor. It consisted of abundant fibrosis with hyalinised vessels, containing mononuclear infiltrate and foci of psammomatous calcifications (<xref ref-type="fig" rid="F1">Fig. 1</xref>). Lymphoid follicles were noted around vessels and psammomas (<xref ref-type="fig" rid="F2">Fig. 2</xref>). The tumor did not show any features of malignancy. Immunohistochemically, the spindle cells were vimentin positive (<xref ref-type="fig" rid="F3">Fig. 3</xref>) and vessels showed CD34 positivity. These features confirmed the diagnosis of Calcifying fibrous tumors. At 4 years of follow-up, the patient was asymptomatic and there was no recurrence. <fig id="F1"> <label>Figure 1</label> <caption> Tumor composed of abundant fibrosis with hyalinised vessels, containing mononuclear infiltrate and foci of psammomatous calcifications. </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-487-g001.tif"/> </fig> <fig id="F2"> <label>Figure 2</label> <caption> Lymphoid follicles were noted around vessels and psammomas. </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-487-g002.tif"/> </fig> <fig id="F3"> <label>Figure 3</label> <caption> Spindle cells showing strong expression of vimentin. </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-487-g003.tif"/> </fig> The patient’s informed consent was obtained. Prior to the study, patient gave written consent to the examination and biopsy after having been informed about the procedure. Calcifying fibrous tumor (CFT) is a rare, usually solitary, benign tumor of uncertain etiology. The most common sites are the soft tissues of the extremities, pleura, or peritoneum [<xref ref-type="bibr" rid="ref1">1</xref>]. It usually affects children and young adults, and it is composed of hyalinized fibrous tissue with dispersed bland fibroblastic spindled cells, scattered psammomatous, and/or dystrophic calcifications, and variably prominent mononuclear inflammatory infiltrate [<xref ref-type="bibr" rid="ref2">2</xref>]. Macroscopically, CFT is well circumscribed and unencapsulated. Its diameter ranges from 1 to 15 cm. Their etiopathogenesis has not been fully clarified yet. However, in the literature, there are cases that may be related to trauma and Castleman’s disease [<xref ref-type="bibr" rid="ref3">3</xref>]. Resection of CFT is usually curative. Local recurrence rate is approximately 10% [<xref ref-type="bibr" rid="ref1">1</xref>]. <sec id="sec2-1"> <title>Consent

The examination of the patient was conducted according to the Declaration of Helsinki principles. Written informed consent was obtained from the patient for publication of this article.

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Source of Support: Nil

Conflict of Interest: None declared.