Intracranial Angiomatoid Fibrous Histiocytoma: Case Report and Literature Review.
BACKGROUND
Angiomatoid fibrous histiocytoma (AFH) is a rare and low-grade soft tissue lesion that typically arises from subcutaneous and deep dermal tissue of extremities. The first case was reported in 1979 by Enzinger and has since become known as a distinct entity. AFH has been increasingly reported in different organ systems, with rare reports of primary intracranial AFH. To date there have been 3 reports of intracranial AFH and 1 report of metastasis to the brain, most of which were in young adults.


METHODS
In this paper, we present a case of an older patient with a large, petrous apex AFH that was clinically mistaken for a trigeminal nerve schwannoma. We discuss radiographic and histologic features initially found and the findings that ultimately led to the diagnosis of AFH. We also discuss the findings noted in all other reports of intracranial AFH.


CONCLUSIONS
We present a rare case of intracranial AFH in a patient relatively old for onset of diagnosis. To date, only 3 prior cases of AFH have been reported. The radiographic findings were nonspecific and initially pointed toward a diagnosis of schwannoma, whereas histopathology seemed to initially suggest meningioma. Further pathologic consultation finally confirmed AFH as the diagnosis. We suspect there are more cases of intracranial AFH that are misdiagnosed due to variability of findings on pathology. The behavior of this tumor remains in question as 1 of the 3 reported cases demonstrated significant recurrence. As such, gross total resection of this lesion is preferable.
Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA.
Mohammed A
MA
Alshareef
College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Zayed
Z
Almadidy
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Tiffany
T
Baker
Department of Pathology, University of California, San Francisco, San Francisco, California, USA.
Arie
A
Perry
Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Cynthia T
CT
Welsh
Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina, USA. Electronic address: vandergr@musc.edu.
William A
WA
Vandergrift
D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D035301:Cranial Fossa, Middle / Q000000981:diagnostic imaging; D003399:Craniotomy / Q000379:methods*; D005260:Female; D051677:Histiocytoma, Malignant Fibrous / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D011956:Receptors, Cell Surface / Q000378:metabolism; D053668:Syndecan-1 / Q000378:metabolism; D013702:Temporal Lobe / Q000000981:diagnostic imaging; D000098902:CD163 Antigen
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D000098902:CD163 Antigen; D011956:Receptors, Cell Surface; D053668:Syndecan-1
Angiomatoid fibrous histiocytoma; Brain tumor; Intracranial tumor; Petrous apex tumor; Schwannoma