Treatment of angiomatoid fibrous histiocytoma after unplanned excision: a case report

Abstract

BackgroundAngiomatoid fibrous histiocytoma (AFH) is a relatively uncommon soft tissue tumor of intermediate biologic potential. It occurs in subcutaneous regions of the extremities or the trunk, usually presenting in children or young adults. This is the first reported case of subcutaneous AFH that developed in the iliac region and was treated with an unplanned resection.Case presentationAn 11-year-old girl noticed a small subcutaneous nodule in the iliac region. As the nodule was asymptomatic, it was observed naturally for a year, after which her parents consulted her doctor due to gradual growth of the nodule. The tumor was resected marginally without biopsy by a non-specialized surgeon. Based on the histology of the resected specimen, the tumor was suspected to be a sarcoma. The patient was referred to our hospital where we reinvestigated the histology of the tumor using immunohistochemistry. After confirming diagnosis of the tumor as an AFH, we undertook additional extensive resection in the iliac region where the tumor had developed. There was no evidence of tumor residue in the resected specimen. It has been 3 years since the operation, and there has been no evidence of recurrence.ConclusionWe treated a case of AFH after unplanned resection. If subcutaneous tumors in the iliac region are detected, a diagnosis of AFH should be considered and a simple resection avoided.

Angiomatoid Fibrous Histiocytoma in an Elderly Male: An Unusual Presentation of a Rare Case

“…These cases are usually treated with surgical excision with a wide local excision. 9 , 10 However, radiation therapy is utilized in cases where marginal excision is planned depending on the surgeon’s point of view. The literature shows different recurrence and metastasis rates in these cases.…”

Angiomatoid Fibrous Histiocytoma, A Great Mimicker – A Short Series of 3 Cases with EWSR1 Fusion

“…Due to this minor chance of local recurrence, all AFH are treated with wide excision. Even cases who have undergone unplanned resections or were misdiagnosed initially should undergo additional extended resections ( 24 ). Follow-ups for 19 months, 61 months, and 45 months were available for case 3, case 2, and case 1, respectively, and all were uneventful.…”

Tocilizumab Controls Paraneoplastic Inflammatory Syndrome but Does Not Suppress Tumor Growth of Angiomatoid Fibrous Histiocytoma

“…Therefore, it is often radically resected with a wide margin [5]. Sometimes, unplanned surgery is performed in subcutaneous tumors, including AFH, which may cause local recurrence or distant metastasis [6,7]. Few studies have reported on the effective treatment for metastatic or unresectable AFH.…”