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Michcik A, Bień M, Wojciechowska B, Polcyn A, Garbacewicz Ł, Kowalski J, Drogoszewska B. Difficulties in diagnosing angiomatoid fibrous histiocytoma of the head and neck region: A case report. World J Clin Cases 2023; 11:6252-6261. [PMID: 37731558 PMCID: PMC10507541 DOI: 10.12998/wjcc.v11.i26.6252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Angiomatoid fibrous histiocytoma (AFH) is a rare, slow-growing soft tissue tumor. It appears mostly on the limbs and trunk in children and young adults. The biology of AFH remains unclear because of the small number of reported cases. Diagnostic testing does not provide definitive results. It has two clinical forms, that differ in terms of gene expression and clinical prognosis. It is important to inform the laboratory which specific gene testing is necessary. Here, we describe a case of rare AFH in the submandibular region using a full genetic panel. CASE SUMMARY A 13-year-old boy who had been misdiagnosed in the past 6 mo by his dentist visited our clinic because of a lesion in the submandibular area on the right side. The lesion was homogeneous and painless upon palpation. No skin discoloration was observed. Due to the non-specific radiological picture computed tomography (CT), magnetic resonance imaging (MRI), cone-beam CT (CBCT), and ultrasound-guided biopsy were performed. A venous malformation was suspected on the MRI. None of the tests provided a definitive diagnosis. Owing to the non-specific radiological findings, the patient qualified for surgical treatment. The surgical procedure included an excisional biopsy. The diagnostic testing was extended using gene rearrangements. The most distinctive gene translocation in diagnosing AFH is within the EWS RNA-binding protein 1 (EWSR1)-CREB-binding protein. However, in this case, the diagnosis was confirmed by a rearrangement within the EWSR1 gene testing. CONCLUSION AFH in the submandibular location is rare, and surgical treatment with genetic evaluation defines AFH type that affects subsequent procedures.
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Affiliation(s)
- Adam Michcik
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Marta Bień
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Barbara Wojciechowska
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Adam Polcyn
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Łukasz Garbacewicz
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Jacek Kowalski
- Department of Pathomorphology, Medical University of Gdańsk, Gdańsk 80-214, Poland
| | - Barbara Drogoszewska
- Department of Maxillofacial Surgery, Medical University of Gdańsk, Gdańsk 80-214, Poland
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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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Maqbool H, Bashir S, Hassan U, Hussain M, Mushtaq S, Ishtiaq S. Angiomatoid Fibrous Histiocytoma: A Tumor With Uncertain Behavior and Various Clinicopathological Presentations. Cureus 2022; 14:e28985. [PMID: 36225497 PMCID: PMC9541999 DOI: 10.7759/cureus.28985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2022] [Indexed: 01/06/2023] Open
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