title: Atypical fibroxanthoma developing on a pacemaker pocket mimicking a pyogenic granuloma.
abstract: Malignant tumors at the site of implantation of a pacemaker generator, although rare, have been reported in the literature. We present a case of an 89-year-old man with atypical fibroxanthoma in a pacemaker pocket. The device had been implanted for more than 4 years. An exophytic tumor had developed in this place and was clinically interpreted as a pyogenic granuloma. An excisional biopsy revealed the nature of the tumor. To our knowledge, the association of atypical fibroxanthoma arising from a pacemaker pocket has not been previously reported. A review of the literature has revealed four malignant soft tissue tumors previously reported at the pacemaker site. Routine examination in all patients with implanted pacemaker generators should be practiced at follow-up visits. This would allow an early diagnosis of a malignant associated neoplasm. Pathologists should become familiar with this type of devices and their potential neoplastic complications.
authors.affiliation: Service of Pathology, Marqués de Valdecilla University Hospital, Medical Faculty, University of Cantabria, and IFIMAV, Santander, Spain.
authors.forename: M Carmen
authors.initials: MC
authors.lastname: González-Vela
authors.forename: Waleska
authors.initials: W
authors.lastname: Salcedo
authors.forename: Carlos
authors.initials: C
authors.lastname: Neira
authors.forename: Marcos A
authors.initials: MA
authors.lastname: González-López
authors.forename: Higinio
authors.initials: H
authors.lastname: Ayala
authors.forename: J Fernando
authors.initials: JF
authors.lastname: Val-Bernal
mesh_terms: D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003951:Diagnostic Errors; D004867:Equipment Design; D015745:Granuloma, Foreign-Body / Q000209:etiology / Q000473:pathology*; D017789:Granuloma, Pyogenic / Q000209:etiology / Q000473:pathology*; D051677:Histiocytoma, Malignant Fibrous / Q000737:chemistry / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012878:Skin Neoplasms / Q000737:chemistry / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor