Hashimoto Kazuhiko, Nishimura Shunji, Kakinoki Ryosuke, Akagi Masao
Department of Orthopedic Surgery, Kindai University Hospital, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
BMC Res Notes. 2018 Aug 31;11(1):628. doi: 10.1186/s13104-018-3736-4.
Angiomatoid 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.
An 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.
We 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.
血管样纤维组织细胞瘤（AFH）是一种生物学行为介于良恶性之间的相对罕见的软组织肿瘤。它发生于四肢或躯干的皮下区域，常见于儿童或青年。这是首例报道的发生于髂区的皮下AFH病例，且接受了非计划性切除治疗。
一名11岁女孩发现髂区有一个小的皮下结节。由于该结节无症状，自然观察了一年，之后因其逐渐长大，父母带她就医。肿瘤由一名非专科外科医生在未进行活检的情况下进行了边缘切除。根据切除标本的组织学表现，怀疑肿瘤为肉瘤。患者被转诊至我院，我们使用免疫组化对肿瘤组织学进行了重新检查。在确诊肿瘤为AFH后，我们在肿瘤发生的髂区进行了额外的广泛切除。切除标本中未发现肿瘤残留迹象。手术已过去3年，无复发迹象。
我们治疗了一例非计划性切除后的AFH病例。如果在髂区发现皮下肿瘤，应考虑AFH的诊断并避免单纯切除。
