Banias Laura, Gurzu Simona, Jung Ioan, Borz Cristian
Department of Pathology, University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mureş, Romania.
Department of Surgery, University of Medicine, Pharmacy, Sciences and Technology, Tirgu-Mureş, Romania.
Postepy Dermatol Alergol. 2019 Apr;36(2):223-226. doi: 10.5114/ada.2019.84597. Epub 2019 May 14.
Angiomyofibroblastoma is a rare benign myofibroblastic neoplasm which mainly occurs in the soft tissues of the pelvi-perineal region of females.
To present an unusual case of angiomyofibroblastoma mimicking an inguinal hernia in a 62-year-old male.
The patient was hospitalized with an irreducible, painless inguinal mass and surgical intervention for inguinal hernia was decided. The well-defined nodular mass was sent for histological examination.
Under microscope, proliferation of spindle and oval cells around thin-walled vessels was observed, being intermingled with mature adipocytes. We did not identify necrosis, haemorrhage, cytologic atypia or mitotic figures. The tumour cells displayed positivity for desmin, vimentin, CD34, oestrogen and progesterone receptors, a low Ki67 index and unusual nuclear positivity for c-theta (PKCθ). They were negative for smooth muscle actin (SMA), S100, CD44, maspin, synaptophysin, DOG1 and CD117. The case was diagnosed as angiomyofibroblastoma, the main challenge being the differential diagnosis with aggressive angiomyxoma, which can present a similar histologic aspect and immunophenotype and recurs more frequently. No recurrences were observed 8 months after the surgery.
Angiomyofibroblastoma should be included in the differential diagnosis of inguinal hernia. This is the fourteenth case of angiomyofibroblastoma diagnosed in males.
血管肌纤维母细胞瘤是一种罕见的良性肌纤维母细胞性肿瘤，主要发生于女性盆腔 - 会阴区的软组织。
报告一例62岁男性血管肌纤维母细胞瘤酷似腹股沟疝的不寻常病例。
患者因不可复性、无痛性腹股沟肿块入院，决定行腹股沟疝手术干预。将边界清晰的结节状肿块送检做组织学检查。
显微镜下可见薄壁血管周围梭形和椭圆形细胞增生，与成熟脂肪细胞混杂。未发现坏死、出血、细胞异型性或核分裂象。肿瘤细胞结蛋白、波形蛋白、CD34、雌激素和孕激素受体呈阳性，Ki67指数低，c - 西塔（蛋白激酶C西塔）核阳性异常。平滑肌肌动蛋白（SMA）、S100、CD44、乳腺丝抑蛋白、突触素、DOG1和CD117呈阴性。该病例诊断为血管肌纤维母细胞瘤，主要挑战是与侵袭性血管黏液瘤进行鉴别诊断，后者可呈现相似的组织学表现和免疫表型且复发更频繁。术后8个月未观察到复发。
血管肌纤维母细胞瘤应纳入腹股沟疝的鉴别诊断。这是第14例诊断为男性的血管肌纤维母细胞瘤病例。
