Institute of Hematology and Transfusiology Medicine, Warsaw, Poland: Department of General, Oncological and Metabolic Surgery.
Institute of Hematology and Transfusiology Medicine, Warsaw, Poland: Department of Patomorphology.
Pol Merkur Lekarski. 2021 Jun 16;49(291):221-223.
Atypical fibrous histiocytoma (AFH) is an uncommon variant of benign skin neoplasm, fibrous histiocytoma. Despite having pseudosarcomatous histological features, atypical fibrous histiocytoma is characterized by a benign clinical course.
The aim of the study was to present the case of local recurrence of atypical fibrous histiocytoma in scar after the primary excision.
A 28-year-old woman was admitted due to a slowgrowing 10 mm skin tumor of the left elbow, which has been observed for 18 months. Physical examination revealed that the tumor was covered by normal skin, firm, painless and movable. Tumor was excised and the wound was healed properly. Histopathological examination revealed AFH with normal tissue margins below 1 mm. It was decided to increase the excision. After 4 months patient was admitted for an extended resection. Physical examination showed no abnormalities within the scar. Despite this the primary procedure was radicalized and the scar with margins was excised. Histopathological examination reveals a subcuticular, single-site, 2 mm recurrent atypical fibrous histiocytoma with a surrounding of 2-10 mm normal tissue margin. The patient remains in follow-up the scar reveals no irregularities. The excisional biopsy followed by an extended resection makes a complete recovery.
The probability of a too small surgical margin (<1 mm) could contribute to the local recurrence of atypical fibrous histiocytoma.
非典型纤维组织细胞瘤(AFH)是一种罕见的良性皮肤肿瘤——纤维组织细胞瘤的变体。尽管具有假肉瘤样组织学特征,但非典型纤维组织细胞瘤的临床过程是良性的。
本研究旨在报告一例原发性切除后瘢痕内非典型纤维组织细胞瘤局部复发的病例。
一名 28 岁女性因左肘 10mm 缓慢生长的皮肤肿瘤就诊,该肿瘤已观察 18 个月。体格检查显示肿瘤被正常皮肤覆盖,质地坚硬,无痛且可移动。肿瘤被切除,伤口愈合良好。组织病理学检查显示有 1mm 以下正常组织边界的非典型纤维组织细胞瘤。决定扩大切除范围。4 个月后,患者因广泛切除而入院。体格检查显示瘢痕内无异常。尽管如此,仍进行了根治性手术,切除了带有边界的瘢痕。组织病理学检查显示,在 2-10mm 正常组织边界内存在一个皮下、单一部位、2mm 的复发性非典型纤维组织细胞瘤。患者仍在随访中,瘢痕无异常。切除活检后行广泛切除可获得完全康复。
手术切缘过小(<1mm)可能导致非典型纤维组织细胞瘤的局部复发。