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Nova-Camacho LM, Razquín S, Panizo A. Angiomatoid Fibrous Histiocytoma of the Chest Wall Protruding into the Thoracic Cavity Mimicking Metastasis in a Patient with Breast Cancer. Int J Surg Pathol 2023:10668969231213387. [PMID: 38124307 DOI: 10.1177/10668969231213387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor of intermediate malignancy and uncertain differentiation. To date, only four patients diagnosed with AFH located in the chest wall have been described. Herein, we describe a 44-year-old woman diagnosed with breast infiltrating lobular carcinoma. During the imaging study with positron emission tomography-computerized tomography scan, a 4 cm solid lesion located in the chest wall was identified. Fine-needle aspiration followed by surgical excision with intraoperative frozen section study was performed. The combined histomorphologic, immunohistochemical, and molecular findings confirmed the diagnosis of AFH. In this report, we describe, to the best of our knowledge, the first patient with synchronous AFH and breast cancer.
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Affiliation(s)
| | - Socorro Razquín
- Department of Pathology, University Hospital of Navarra, Pamplona, Spain
| | - Angel Panizo
- Department of Pathology, University Hospital of Navarra, Pamplona, Spain
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2
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Mankertz F, Keßler R, Rau A, Seebauer C, Ribback S, Busemann A. Pulmonary Metastasising Aneurysmal Fibrous Histiocytoma: A Case Report, Literature Review and Proposal of Standardised Diagnostic Criteria. Diseases 2023; 11:108. [PMID: 37754304 PMCID: PMC10530133 DOI: 10.3390/diseases11030108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
An aneurysmal fibrous histiocytoma is a rare cutaneous soft-tissue tumour which accounts for approximately 0.06% of all dermatopathologies. Metastasis is exceedingly uncommon, to the point that there have only been eight reported cases in the scientific literature. We present the case of a 25-year-old male with a primary aneurysmal fibrous histiocytoma located in the nuchal region which exhibited rapid growth and abrupt ulceration over a short time span and showed signs of locoregional aggressive infiltration. A subsequent histopathological analysis confirmed the presence of diffuse solid and cystic pulmonary metastases. Further genetic sequencing verified LAMTOR1-PRKCD fusion. This case report seeks to review the existing literature on aneurysmal fibrous histiocytoma, discuss the challenges of differential diagnosis and propose standardised diagnostic criteria.
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Affiliation(s)
- Fiona Mankertz
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Rebecca Keßler
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery/Plastic Operations, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Christian Seebauer
- Department of Oral and Maxillofacial Surgery/Plastic Operations, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Silvia Ribback
- Institute of Pathology, University Medicine Greifswald, Friedrich-Loeffler-Straße 23e, 17475 Greifswald, Germany
| | - Alexandra Busemann
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
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3
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Corley EA, Pace E, Barnacle AM, Patel PA, Thway K, Chisholm JC. Evidence of Chemoresponsiveness in Unresectable Metastatic Angiomatoid Fibrous Histiocytoma. J Pediatr Hematol Oncol 2023; 45:e279-e284. [PMID: 36716049 DOI: 10.1097/mph.0000000000002612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 11/13/2022] [Indexed: 01/31/2023]
Abstract
Angiomatoid fibrous histiocytoma (AFH) is a soft tissue neoplasm of intermediate biological potential. Typically a slow-growing tumor, it can recur locally. Rarely, it manifests as a soft tissue sarcoma capable of metastasis. When metastases are nonamenable to local therapy, it is believed uniformly fatal. We present 3 patients with metastatic AFH who demonstrated a sustained response to chemotherapy; including one who achieved complete remission with cryoablation. These cases reinforce the potential value of chemotherapy in some patients with unresectable metastatic AFH and provide the first case in the literature of cryoablation in AFH.
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Affiliation(s)
- Elizabeth A Corley
- Paediatric and Adolescent Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton
| | - Erika Pace
- Department of Diagnostic Radiology, The Royal Marsden Hospital
| | - Alex M Barnacle
- Department of Radiology, Great Ormond Street Hospital for Children
| | - Premal A Patel
- Department of Radiology, Great Ormond Street Hospital for Children
| | - Khin Thway
- Sarcoma Unit, The Royal Marsden Hospital, London, UK
| | - Julia C Chisholm
- Paediatric and Adolescent Oncology Drug Development Team, Children and Young People's Unit, Royal Marsden Hospital and Institute of Cancer Research, Sutton
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4
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Cazzato G, Lupo C, Casatta N, Riefoli F, Marzullo A, Colagrande A, Cascardi E, Trabucco SMR, Ingravallo G, Moretti B, Maiorano E, Pesce V, Resta L. Angiomatoid Fibrous Histiocytoma (AFH) of the Right Arm: An Exceptional Case with Pulmonary Metastasis and Confirmatory EWSR1::CREB1 Translocation. Diagnostics (Basel) 2022; 12:2616. [PMID: 36359460 PMCID: PMC9689933 DOI: 10.3390/diagnostics12112616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 09/08/2023] Open
Abstract
Angiomatoid fibrous histiocytoma (AFH) is a rare neoplasm described for the first time by Enzinger in 1979, and classified by World Health Organization 2020 as intermediate malignant potential neoplasm. It mostly occurs in the subcutis and is characterized by varying proportions of epithelioid, ovoid and spindle cells in a nodular and syncytial growth pattern, with some hemorrhagic pseudovascular spaces. In this paper, we report the clinical case of a 62-year-old man who presented with AFH on the right arm, and relapsed three years after first surgical excision. After a further three years, the patient presented with an intramuscular localization of AFH, and 12 months after this, a pulmonary metastasis of AFH was diagnosed. Given the rarity of the spreading of AFH, we performed Fluorescence In Situ Hybridization (FISH) and we detected EWSR1::CREB1 gene fusion.
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Affiliation(s)
- Gerardo Cazzato
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Carmelo Lupo
- Innovation Department, Diapath S.P.A., Via Savoldini n.71, 24057 Martinengo, Italy
| | - Nadia Casatta
- Innovation Department, Diapath S.P.A., Via Savoldini n.71, 24057 Martinengo, Italy
| | - Flavia Riefoli
- Section of Orthopedics and Traumatology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Andrea Marzullo
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Anna Colagrande
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142, km 3.95, 10060 Candiolo, Italy
| | - Senia Maria Rosaria Trabucco
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Giuseppe Ingravallo
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Biagio Moretti
- Section of Orthopedics and Traumatology, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Eugenio Maiorano
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
| | - Vito Pesce
- Section of Orthopedics and Traumatology, Department of Clinical and Experimental Medicine, University of Foggia, 71100 Foggia, Italy
| | - Leonardo Resta
- Section of Molecular Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy
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Ngo C, Grinda T, Boilève A, Levy A, Le-Pechoux C, Haddag L, Valent A, Lazure T, Briand S, Honoré C, Faron M, Mir O, Bahleda R, Verret B, Le Cesne A. Durable response to crizotinib in metastatic angiomatoid fibrous histiocytoma with EWSR1-CREB1 fusion and ALK overexpression. Ann Oncol 2022; 33:848-850. [PMID: 35568279 DOI: 10.1016/j.annonc.2022.05.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/07/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Carine Ngo
- Department of Biology and Pathology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremlin-Bicêtre, France
| | - Thomas Grinda
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Alice Boilève
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremlin-Bicêtre, France
| | - Antonin Levy
- Department of Radiation Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France; Université Paris-Saclay, Faculté de Médecine, 94270 Le Kremlin-Bicêtre, France
| | - Cecile Le-Pechoux
- Department of Radiation Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Leila Haddag
- Department of Radiology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Alexander Valent
- Department of Biology and Pathology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Thierry Lazure
- Department of Pathology, Bicêtre Hospital, Université Paris-Saclay, 78, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Sylvain Briand
- Department of Orthopaedics and Traumatology, Bicêtre Hospital, Université Paris-Saclay, 78, rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Charles Honoré
- Department of Surgery, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Matthieu Faron
- Department of Surgery, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Olivier Mir
- Department of Ambulatory Cancer Care, Gustave Roussy, 94800 Villejuif, France
| | - Ratio Bahleda
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Benjamin Verret
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France
| | - Axel Le Cesne
- Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800 Villejuif, France.
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Vizcaino MA, Giannini C, Chang HT, Kipp BR, Fritchie K, Vaubel R. Intracranial angiomatoid fibrous histiocytoma with rhabdoid features: a mimic of rhabdoid meningioma. Brain Tumor Pathol 2021; 38:138-144. [PMID: 33432531 DOI: 10.1007/s10014-020-00389-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/07/2020] [Indexed: 02/07/2023]
Abstract
Angiomatoid fibrous histiocytoma (AFH) is an uncommon soft-tissue neoplasm that arises mostly in the extremities of young people and generally carries a good prognosis. Intracranial location is unusual and frequently associated with myxoid change. EWSR1 gene fusions with members of the CREB family (CREB1, ATF1, and CREM) are well-established events in AFH. These fusions have also been described in other neoplasms including intracranial myxoid mesenchymal tumor, and it is still uncertain whether the latter is a distinct entity or if it represents a myxoid variant of AFH. Here, we describe a rare falcine AFH presenting in a 50-year-old woman. The most striking feature of this tumor was its diffuse rhabdoid morphology with focal high mitotic activity, raising the consideration of rhabdoid meningioma (WHO grade III). The tumor cells were moderately positive for EMA and negative for progesterone receptor and SSTR2 prompting additional studies. Desmin was strongly positive and CD99 showed membranous immunoreactivity. BAP1, INI-1, and BRG1 expressions were retained. Next-generation sequencing analysis demonstrated an EWSR1-ATF1 gene fusion, supporting the diagnosis of an unusual rhabdoid variant of AFH. After gross total resection of this tumor, the patient remains free of disease 5 months after the surgery without additional treatment.
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Affiliation(s)
- M Adelita Vizcaino
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, 200 1st St SW, Rochester, MN, 55905, USA
| | - Caterina Giannini
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, 200 1st St SW, Rochester, MN, 55905, USA
| | - Howard T Chang
- Department of Pathology, Sparrow Hospital, Lansing, 1215 E Michigan Ave, Lansing, MI, 48912, USA
| | - Benjamin R Kipp
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, 200 1st St SW, Rochester, MN, 55905, USA
| | - Karen Fritchie
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, 200 1st St SW, Rochester, MN, 55905, USA
| | - Rachael Vaubel
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, 200 1st St SW, Rochester, MN, 55905, USA.
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8
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Jelti L, Alorini M, Boivin C, Courville P, Balguerie X, Bonmarchand A, Angot E. Histiocytome fibreux angiomatoïde de la gouttière du pouls radial. Ann Dermatol Venereol 2018; 145:756-760. [DOI: 10.1016/j.annder.2018.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 02/25/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
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9
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Potter SL, Quintanilla NM, Johnston DK, Naik-Mathuria B, Venkatramani R. Therapeutic response of metastatic angiomatoid fibrous histiocytoma carrying EWSR1-CREB1 fusion to the interleukin-6 receptor antibody tocilizumab. Pediatr Blood Cancer 2018; 65:e27291. [PMID: 29932283 DOI: 10.1002/pbc.27291] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 05/09/2018] [Accepted: 05/24/2018] [Indexed: 11/12/2022]
Abstract
Angiomatoid fibrous histiocytoma (AFH) is a rare soft tissue tumor that has been associated with EWSR1-CREB1 gene fusion. Outcome in patients with unresectable distant metastases is generally fatal. Interleukin-6 (IL-6) secretion has been described in tumors with EWSR1-CREB1 fusion, and may promote tumor growth due to autocrine stimulation. Tocilizumab is an IL-6 receptor antibody that has potential benefit as a targeted therapy in refractory neoplasms with IL-6 secretion. We describe a child with metastatic AFH with EWSR1-CREB1 fusion and elevated IL-6 whose disease progressed during treatment with traditional chemotherapeutic agents, but improved after targeted therapy with tocilizumab.
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Affiliation(s)
- Samara L Potter
- Department of Pediatrics, Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Norma M Quintanilla
- Department of Pathology and Immunology, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Danielle K Johnston
- Department of Pediatrics, Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Bindi Naik-Mathuria
- Department of Surgery, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Rajkumar Venkatramani
- Department of Pediatrics, Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas
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Tay CK, Koh MS, Takano A, Aubry MC, Sukov WR, Folpe AL. Primary angiomatoid fibrous histiocytoma of the lung with mediastinal lymph node metastasis. Hum Pathol 2016; 58:134-137. [PMID: 27544801 DOI: 10.1016/j.humpath.2016.07.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/20/2016] [Accepted: 07/22/2016] [Indexed: 10/21/2022]
Abstract
Angiomatoid fibrous histiocytoma (AFH), a rare soft tissue tumor of borderline malignancy, typically occurs in the subcutis of the accessible soft tissues, most often in children and young adults. Lymph node and/or distant metastasis is seen in less than 2% of patients with AFH. Exceptionally rare examples of AFH have been reported in visceral locations, including the lung. We report a genetically confirmed primary pulmonary AFH in a 70-year-old woman with mediastinal lymph node metastasis, representing to the best of our knowledge the first report of metastases from a visceral AFH.
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Affiliation(s)
- Chee Kiang Tay
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Outram Road, Singapore 169608
| | - Mariko Siyue Koh
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Outram Road, Singapore 169608
| | - Angela Takano
- Department of Pathology, Singapore General Hospital/Duke-NUS Graduate Medical School, Outram Road, Singapore 169608
| | - Marie Christine Aubry
- Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - William R Sukov
- Division of Laboratory Genetics, Mayo Clinic, Rochester, MN 55905, USA
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Division of Anatomic Pathology, Mayo Clinic, Rochester, MN 55905, USA.
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Martinez SJ, Moreno CC, Vinson EN, Dodd LG, Brigman BE. Angiomatoid fibrous histiocytoma: novel MR imaging findings. Skeletal Radiol 2016; 45:661-70. [PMID: 26919861 DOI: 10.1007/s00256-016-2344-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/27/2016] [Accepted: 02/01/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To describe novel MR imaging features, and clinical characteristics of soft tissue angiomatoid fibrous histiocytoma (AFH) at presentation, local recurrence, and metastases. MATERIALS AND METHODS We described the MRI findings of six cases of histologically proven AFH. Pathologic findings, clinical presentation, and outcome were reviewed. RESULTS Lesions were primarily cystic. At initial presentation, tumors were surrounded by low signal intensity fibrous pseudocapsule. High signal intensity consistent with the lymphoplasmacytic infiltrate was seen in T2-weighted and post-contrast images as a rim over the hypointense pseudocapsule (double rim sign). High signal intensity infiltrating tumoral cords extended into adjacent tissues, through pseudocapsular defects on T2-weighted and post-contrast images. The cystic component and tumor cell nodularity were demonstrated at post-contrast images. Clinically, lesions were often thought to be benign, underwent marginal resection, developed local recurrence, and one developed second recurrence consisting of metastases. Recurrent tumors appeared as multiple masses, misinterpreted as post-surgical changes. An intramuscular recurrence demonstrated double rim and infiltrating margin. CONCLUSIONS A predominantly well-circumscribed, primarily cystic mass with double-rim and marginal infiltration on MRI suggests the possibility of AFH, in particular in child or young adult. Inclusion of these novel observations in AFH differential diagnosis may have a significant impact on treatment and prevention of recurrence.
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Affiliation(s)
- Salutario J Martinez
- Department of Radiology, Duke University Medical Center, Box 3808 Erwin Road, Durham, NC, 27710, USA.
| | - Courtney Coursey Moreno
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA, 30322, USA
| | - Emily N Vinson
- Department of Radiology, Duke University Medical Center, Box 3808 Erwin Road, Durham, NC, 27710, USA
| | - Leslie G Dodd
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Campus Box #7525 Brinkhous-Bullitt Building, Chapel Hill, NC, 27599, USA
| | - Brian E Brigman
- Department of Orthopedic Surgery, Duke University Medical Center, Box 3312 Erwin Road, Durham, NC, 27710, USA
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