Abstract：
A wide spectrum of tumors may affect the periungual spaces of the digits. Superficial acral fibromyxoma (SAF) is a rare, benign soft tissue tumor with diverse clinical presentations. We present a case of a 55-year-old woman with a 2-year history of a solitary periungual tumor on the left thumb, subjected to multiple episodes of trauma. Initially suspected to be a periungual squamous cell carcinoma (SCC) based on clinical and dermoscopic features, the tumor was confirmed to be a CD34- SAF through histopathology and immunohistochemistry. Although CD34 immunoreactivity is common in SAF, one-third of these tumors, including this case, do not stain for this marker. Periungual SCC considered a \"great mimicker of nail tumors,\" may resemble other benign nail tumors such as SAF. The patient underwent complete surgical excision with primary closure, resulting in no recurrence after 1 year. This case highlights SAF as an underrecognized benign entity that may manifest with features suspicious of malignancy, potentially leading to unnecessarily aggressive interventions. Recognizing SAF through accurate biopsy techniques and thorough histopathologic evaluation, even in the absence of CD34 reactivity, is crucial for appropriate treatment and preservation of hand function and appearance.
摘要：
广泛的肿瘤可能会影响手指的甲周空间。肢端浅表纤维粘液瘤（SAF）是一种罕见的，良性软组织肿瘤，临床表现多样。我们介绍了一例55岁的女性，其左手拇指上有2年的孤立性甲周肿瘤病史，遭受多次创伤。根据临床和皮肤镜特征，最初怀疑是甲周围鳞状细胞癌（SCC）。通过组织病理学和免疫组织化学证实肿瘤为CD34-SAF.尽管CD34免疫反应性在SAF中很常见，这些肿瘤的三分之一，包括这个案子,不要为这个标记染色。甲周SCC被认为是指甲肿瘤的伟大模拟者，“可能类似于其他良性指甲肿瘤，如SAF。患者接受了完整的手术切除，并进行了一期闭合，导致1年后无复发。该病例强调SAF是一种未被认可的良性实体，可能表现为可疑的恶性肿瘤。可能导致不必要的积极干预。通过准确的活检技术和彻底的组织病理学评估认识到SAF，即使在没有CD34反应性的情况下，对于适当的治疗和保存手的功能和外观至关重要。
