{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:31:03Z","timestamp":1787923863336,"version":"build-2784847793"},"reference-count":8,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>Ossifying Fibromyxoid Tumor (OFMT) is a rare mesenchymal neoplasm of intermediate biological potential that typically presents as a slow-growing mass. We report a diagnostic challenge involving a 54-year-old male with a 20-year history of a thigh mass that recently exhibited rapid enlargement and ulceration. Initial superficial biopsy led to a high suspicion of cutaneous tuberculosis due to false-positive acid-fast bacilli (AFB) staining and a positive T-SPOT, despite negative tuberculosis serology and normal inflammatory markers. This diagnostic pitfall was attributed to the \u201cshell\u201d of superficial ossification, which caused sampling error and nonspecific dye retention mimicking mycobacteria. Computed tomography (CT) was pivotal in resolving this discrepancy by revealing a characteristic \u201ccore\u2013shell\u201d pattern\u2014a well-defined soft tissue tumor core beneath a dense ossified layer. Following a multimodal diagnostic integration, the patient underwent wide local excision with a 2.0\u00a0cm margin and reconstruction via split-thickness skin grafting. Histopathology and immunohistochemistry, showing partial loss of INI-1 expression, confirmed the diagnosis of OFMT. No recurrence or metastasis was observed during a 2-year follow-up. This case underscores the necessity of imaging to bypass biopsy limitations imposed by superficial ossification and highlights the risk of inappropriate anti-tuberculosis therapy when microbiological morphology conflicts with the broader clinical and radiological picture.<\/jats:p>","DOI":"10.3389\/fonc.2026.1880459","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:51:07Z","timestamp":1787921467000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Revealing the truth: how superficial ossification mimics cutaneous tuberculosis in ossifying fibromyxoid tumor"],"prefix":"10.3389","volume":"16","author":[{"given":"Chao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Burn and Plastic Surgery, West China School of Medicine, Sichuan University, Sichuan University Affiliated Chengdu Second People\u2019s Hospital, Chengdu Second People\u2019s Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Burn and Plastic Surgery, West China School of Medicine, Sichuan University, Sichuan University Affiliated Chengdu Second People\u2019s Hospital, Chengdu Second People\u2019s Hospital","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198910000-00001","article-title":"Ossifying fibromyxoid tumor of soft parts. A clinicopathological analysis of 59 cases","volume":"13","author":"Enzinger","year":"1989","journal-title":"Am J Surg Pathol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0560.2006.00540.x","article-title":"Subcutaneous ossifying fibromyxoid tumor","volume":"33","author":"Soldano","year":"2006","journal-title":"J Cutan Pathol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200304000-00001","article-title":"Ossifying fibromyxoid tumor of soft parts: a clinicopathologic study of 70 cases with emphasis on atypical and Malignant variants","volume":"27","author":"Folpe","year":"2003","journal-title":"Am J Surg Pathol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1097\/PAS.0b013e318160736a","article-title":"Ossifying fibromyxoid tumor of soft parts--a clinicopathologic and immunohistochemical study of 104 cases with long-term follow-up and a critical review of the literature","volume":"32","author":"Miettinen","year":"2008","journal-title":"Am J Surg Pathol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.4997\/JRCPE.2021.411","article-title":"Challenge of a false-positive acid-fast bacilli: a diagnostic conundrum","volume":"51","author":"Kumar","year":"2021","journal-title":"J R Coll Physicians Edinb"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000001533","article-title":"Pattern of cross-reactivity between mycobacterial immunohistochemical stain and normal human eosinophils: a potential pitfall in the diagnosis of cutaneous mycobacterial infections","volume":"42","author":"Baker","year":"2020","journal-title":"Am J Dermatopathol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3182284a3f","article-title":"Ossifying fibromyxoid tumor of soft parts: a clinicopathologic, proteomic, and genomic study","volume":"35","author":"Graham","year":"2011","journal-title":"Am J Surg Pathol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2016.10.012","article-title":"Ossifying fibromyxoid tumor: a study of 6 cases of atypical and Malignant variants","volume":"60","author":"Dantey","year":"2017","journal-title":"Hum Pathol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1880459\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:51:15Z","timestamp":1787921475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1880459\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":8,"alternative-id":["10.3389\/fonc.2026.1880459"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1880459","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"article-number":"1880459"}}