title: Mitotically active deep juvenile xanthogranuloma.
abstract: Juvenile xanthogranuloma is a relatively rare cutaneous tumor of histiocytic origin, occurring mainly in neonates, children, and young people in the first 2 decades of life. An occurrence in adults is rare. Very rare is also a "deep" subcutaneous and intramuscular localization of this tumor that is called in such case as "deep juvenile xanthogranuloma." A very uncommon variant of this tumor is the so-called mitotically active xanthogranuloma, which was described in the literature only in a single case. We present an interesting case of the mitotically active intramuscular juvenile xanthogranuloma of the upper arm in a 28-year-old woman. Before surgical excision, the tumor was examined by fine-needle aspiration biopsy. A diagnosis of deep malignant melanoma or alveolar rhabdomyosarcoma was considered. One year after the total excision, the patient is free of disease. In the presented case, we emphasize cytologic-histologic correlation. In the differential diagnosis, we considered especially an atypical diffuse giant cell tumor of tendon sheaths and joints (extra-articular pigmented villonodular synovitis) and some rare types of soft tissue leiomyosarcoma, such as epitheloid leiomyosarcoma and leiomyosarcoma with prominent osteoclast-like giant cells.
authors.affiliation: Cytopathos s.r.o., Bratislava, Slovak Republic. koren@medi-email.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Koren
authors.forename: Ludovit
authors.initials: L
authors.lastname: Matecek
authors.forename: Michal
authors.initials: M
authors.lastname: Zamecnik
mesh_terms: D000328:Adult; D015415:Biomarkers; D044963:Biopsy, Fine-Needle; D003937:Diagnosis, Differential; D005260:Female; D005870:Giant Cell Tumors / Q000473:pathology; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology; D008545:Melanoma / Q000473:pathology; D008938:Mitosis; D018482:Muscle, Skeletal / Q000473:pathology*; D018232:Rhabdomyosarcoma, Alveolar / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology; D050151:Subcutaneous Fat / Q000473:pathology*; D014972:Xanthogranuloma, Juvenile / Q000473:pathology*
chemical_list: D015415:Biomarkers