Case of atypical fibroxanthoma in the palpebral conjunctiva

Abstract

Background: We report a case of atypical fibroxanthoma that developed in the palpebral conjunctiva.

Case: A 94-year-old woman had a hemorrhagic tumor in the right lower palpebral conjunctiva that was resected, and adjunctive cryotherapy was applied to the surgical bed.

Observations: The tumor was bleeding and appeared as a pale red, elastic but firm nodule approximately 15x16x8 mm in size. It was composed mainly of fibroblast-like cells and pleomorphic histiocyte-like cells. A storiform pattern was observed in the fibroblast-like cells. The tumor stained positive for vimentin, CD68, and CD10, weakly for CD74 and CD99, and was negative for keratin (wide), KL-1, alpha-fetoprotein, myoglobin, S-100, alpha-smooth muscle actin, desmin, leukocyte common antigen, and glial fibrillary acidic protein immunohistochemically. The MIB-1 index was about 10%. From these findings, we diagnosed the tumor as an atypical fibroxanthoma. There has been no recurrence in the 2 years since the resection.

Conclusions: An atypical fibroxanthoma in the palpebral conjunctiva is very rare. The clinical presentation and histological and immunohistochemical studies are helpful in distinguishing between an atypical fibroxanthoma and a malignant fibrous histiocytoma.