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Variant of dermatofibrosarcoma protuberans: bednar tumor.

Kaul R, Kaur N, Dogra SS, Chander B - Indian J Dermatol (2015 Jan-Feb)

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India.

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Sir, Bednar tumor is a rare variant of dermatofibrosarcoma protuberans with melanin pigment in cells... In this report, we present this patient who presented with recurrent postauricular swelling, which was resected twice in the last 5 years... This lesion was diagnosed as Bednar tumor... The cells were seen containing blackish pigment in varying proportions [Figure 2]... Negative results of iron stains were obtained... Bednar tumor consists of spindle-shaped cells resembling fibroblasts and other melanin-containing dendritic cells... The origin of the tumor cells and the histogenesis have not been fully determined and are controversial, but many authors have suggested that Bednar tumor is derived from neuroectodermal cells on the basis of ultrastructural and immunohistological findings and the presence of melanosome-containing cells... In nonpigmented lesions, melanin has been documented only on microscopic examination... They almost always contain immunoreactive S-100 protein... On the other hand, DFSP and Bednar tumor do not always stain for S-100 protein, but CD34 antigen is present in both tumors, and the latter tumor also contains dendritic melanin-bearing cells... In conclusion, complete extirpation with close follow-up care is indicated for this neoplasm although metastases are rare... The recommended treatment is wide excision with 3 cm margins of visibly uninvolved tissue and inclusion of superficial fascia... Because of its rarity, information is lacking regarding the optimal therapy and potential utility of immunohistochemistry in diagnosis, so further investigation is needed.

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Photomicrograph showing pleomorphic spindle cells and intra/extracellular pigment (H and E X40)
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Figure 2: Photomicrograph showing pleomorphic spindle cells and intra/extracellular pigment (H and E X40)

Mentions: A 52-year-old man had a small nodular swelling behind his right pinna for last 5 years. The swelling was excised twice in the past with recurrence. The histopathological records were not available. The patient now presented to us with postauricular swelling which was 5×3×3 cms, grayish black in color, multinodular, nontender, not fixed to the underlying tissue and slightly mobile [Figure 1]. There were no satellite lesions. A fine-needle aspiration of the lesion was performed and Giemsa staining done. The cytologic features revealed a spindle cell lesion with obscuring pigment. The tumor was resected along with fascia and a clinically tumor-free margin. The histopathologic examination revealed proliferating spindle cells arranged in storiform pattern, with mild pleomorphism, inconspicuous nucleoli and mild to moderate mitotic activity. The overlying skin was free. The pleomorphic cells were seen infiltrating into the underlying dermis around appendages and into the subcutaneous tissue. The cells were seen containing blackish pigment in varying proportions [Figure 2]. Negative results of iron stains were obtained. Areas of hemorrhage and necrosis could be seen. The immunohistochemistry showed positivity for CD34. A final diagnosis of Bednar tumor was made. The patient is on follow up for the last 6 months without any evidence of recurrence.


Variant of dermatofibrosarcoma protuberans: bednar tumor.

Kaul R, Kaur N, Dogra SS, Chander B - Indian J Dermatol (2015 Jan-Feb)

Photomicrograph showing pleomorphic spindle cells and intra/extracellular pigment (H and E X40)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318047&req=5

Figure 2: Photomicrograph showing pleomorphic spindle cells and intra/extracellular pigment (H and E X40)
Mentions: A 52-year-old man had a small nodular swelling behind his right pinna for last 5 years. The swelling was excised twice in the past with recurrence. The histopathological records were not available. The patient now presented to us with postauricular swelling which was 5×3×3 cms, grayish black in color, multinodular, nontender, not fixed to the underlying tissue and slightly mobile [Figure 1]. There were no satellite lesions. A fine-needle aspiration of the lesion was performed and Giemsa staining done. The cytologic features revealed a spindle cell lesion with obscuring pigment. The tumor was resected along with fascia and a clinically tumor-free margin. The histopathologic examination revealed proliferating spindle cells arranged in storiform pattern, with mild pleomorphism, inconspicuous nucleoli and mild to moderate mitotic activity. The overlying skin was free. The pleomorphic cells were seen infiltrating into the underlying dermis around appendages and into the subcutaneous tissue. The cells were seen containing blackish pigment in varying proportions [Figure 2]. Negative results of iron stains were obtained. Areas of hemorrhage and necrosis could be seen. The immunohistochemistry showed positivity for CD34. A final diagnosis of Bednar tumor was made. The patient is on follow up for the last 6 months without any evidence of recurrence.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Dr. Rajendra Prasad Government Medical College, Tanda, Himachal Pradesh, India.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, Bednar tumor is a rare variant of dermatofibrosarcoma protuberans with melanin pigment in cells... In this report, we present this patient who presented with recurrent postauricular swelling, which was resected twice in the last 5 years... This lesion was diagnosed as Bednar tumor... The cells were seen containing blackish pigment in varying proportions [Figure 2]... Negative results of iron stains were obtained... Bednar tumor consists of spindle-shaped cells resembling fibroblasts and other melanin-containing dendritic cells... The origin of the tumor cells and the histogenesis have not been fully determined and are controversial, but many authors have suggested that Bednar tumor is derived from neuroectodermal cells on the basis of ultrastructural and immunohistological findings and the presence of melanosome-containing cells... In nonpigmented lesions, melanin has been documented only on microscopic examination... They almost always contain immunoreactive S-100 protein... On the other hand, DFSP and Bednar tumor do not always stain for S-100 protein, but CD34 antigen is present in both tumors, and the latter tumor also contains dendritic melanin-bearing cells... In conclusion, complete extirpation with close follow-up care is indicated for this neoplasm although metastases are rare... The recommended treatment is wide excision with 3 cm margins of visibly uninvolved tissue and inclusion of superficial fascia... Because of its rarity, information is lacking regarding the optimal therapy and potential utility of immunohistochemistry in diagnosis, so further investigation is needed.

No MeSH data available.