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Takeda N, Makise N, Lin J, Kageyama H, Oikawa M, Sugiyama T, Kawana H, Araki A, Tuskanishi T, Kinoshita H, Hagiwara Y, Kamoda H, Motoi T, Yonemoto T, Kawazu M, Itami M. Metastasizing aneurysmal dermatofibroma initially diagnosed as angiosarcoma confirmed by CD63::PRKCD fusion gene detection with nanopore sequencing. Genes Chromosomes Cancer 2024; 63:e23246. [PMID: 38747331 DOI: 10.1002/gcc.23246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 04/22/2024] [Accepted: 05/02/2024] [Indexed: 06/14/2024] Open
Abstract
Dermatofibroma (DF) is a benign tumor that forms pedunculated lesions ranging in size from a few millimeters to 2 cm, usually affecting the extremities and trunks of young adults. Histopathologically, DF is characterized by the storiform proliferation of monomorphic fibroblast-like spindle cells. In addition to neoplastic cells, secondary elements such as foamy histiocytes, Touton-type giant cells, lymphoplasmacytes, and epidermal hyperplasia are characteristic histological features. Several histological variants, including atypical, cellular, aneurysmal, and lipidized variants, have been reported; cases with variant histologies are sometimes misdiagnosed as sarcomas. We present a case of metastasizing aneurysmal DF that was initially diagnosed as an angiosarcoma on biopsy. A 26-year-old woman was referred to our hospital with a gradually enlarging subcutaneous mass in her lower left leg. Positron emission tomography-computed tomography revealed high fluorodeoxyglucose uptake not only in the tumor but also in the left inguinal region. On biopsy, ERG and CD31-positive atypical spindle cells proliferated in slit-like spaces with extravasation, leading to the diagnosis of angiosarcoma. Histology of the wide-resection specimen was consistent with DF, and lymph node metastasis was also observed. Nanopore DNA sequencing detected CD63::PRKCD fusion and copy number gain, although CD63 was not included in the target region of adaptive sampling. This report highlights the importance of recognizing the unusual clinical, radiological, and pathological features of DF to avoid misdiagnosis, and the potential diagnostic utility of nanopore sequencer.
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Affiliation(s)
- Naoki Takeda
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Naohiro Makise
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Jason Lin
- Division of Cell Therapy, Chiba Cancer Center, Chiba, Japan
| | - Hajime Kageyama
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Mariko Oikawa
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | | | - Hidetada Kawana
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Akinobu Araki
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
| | - Toshinori Tuskanishi
- Division of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | | | - Yoko Hagiwara
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | - Hiroto Kamoda
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Tsukasa Yonemoto
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | | | - Makiko Itami
- Division of Surgical Pathology, Chiba Cancer Center, Chiba, Japan
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Mankertz F, Keßler R, Rau A, Seebauer C, Ribback S, Busemann A. Pulmonary Metastasising Aneurysmal Fibrous Histiocytoma: A Case Report, Literature Review and Proposal of Standardised Diagnostic Criteria. Diseases 2023; 11:108. [PMID: 37754304 PMCID: PMC10530133 DOI: 10.3390/diseases11030108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 08/17/2023] [Accepted: 08/21/2023] [Indexed: 09/28/2023] Open
Abstract
An aneurysmal fibrous histiocytoma is a rare cutaneous soft-tissue tumour which accounts for approximately 0.06% of all dermatopathologies. Metastasis is exceedingly uncommon, to the point that there have only been eight reported cases in the scientific literature. We present the case of a 25-year-old male with a primary aneurysmal fibrous histiocytoma located in the nuchal region which exhibited rapid growth and abrupt ulceration over a short time span and showed signs of locoregional aggressive infiltration. A subsequent histopathological analysis confirmed the presence of diffuse solid and cystic pulmonary metastases. Further genetic sequencing verified LAMTOR1-PRKCD fusion. This case report seeks to review the existing literature on aneurysmal fibrous histiocytoma, discuss the challenges of differential diagnosis and propose standardised diagnostic criteria.
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Affiliation(s)
- Fiona Mankertz
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Rebecca Keßler
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Andrea Rau
- Department of Oral and Maxillofacial Surgery/Plastic Operations, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Christian Seebauer
- Department of Oral and Maxillofacial Surgery/Plastic Operations, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Silvia Ribback
- Institute of Pathology, University Medicine Greifswald, Friedrich-Loeffler-Straße 23e, 17475 Greifswald, Germany
| | - Alexandra Busemann
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
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Li C, Allen H, Loxas M, Sharma P. Hemosiderotic dermatofibroma mimicking melanoma: A case report and review of the literature. Clin Case Rep 2021; 9:1387-1392. [PMID: 33768851 PMCID: PMC7981605 DOI: 10.1002/ccr3.3780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 12/13/2020] [Indexed: 11/06/2022] Open
Abstract
Hemosiderotic dermatofibroma (HDF) often mimics melanoma clinically. A definite diagnosis relies on histopathological evaluation and immunohistochemistry. As it can progress to aneurysmal dermatofibroma (ADF), complete excision is recommended.
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Affiliation(s)
- Changzhao Li
- Department of PathologyCreighton University School of MedicineOmahaNEUSA
| | - Hunter Allen
- Creighton University School of MedicineOmahaNEUSA
| | | | - Poonam Sharma
- Department of PathologyCreighton University School of MedicineOmahaNEUSA
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Wood KA, Easson AM, Ghazarian D, Saeed Kamil Z. Metastatic aneurysmal fibrous histiocytoma in a 20-year-old woman: A rare case report with review of the literature and discussion of its genomic features. J Cutan Pathol 2020; 47:870-875. [PMID: 32394451 DOI: 10.1111/cup.13738] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 04/21/2020] [Accepted: 04/22/2020] [Indexed: 12/29/2022]
Abstract
Aneurysmal fibrous histiocytoma is an uncommon variant of cutaneous fibrous histiocytomas with a local recurrence rate of 19%. We present a case of aneurysmal fibrous histiocytoma in a 20-year-old female with a regional lymph node metastasis and subsequent satellite nodule. The patient initially presented with a 1-month history of two palpable nodules in left lower anterior shoulder and left axilla. Needle core biopsies from both lesions revealed an atypical spindle cell neoplasm with a differential diagnosis of aneurysmal fibrous histiocytoma and angiomatoid fibrous histiocytoma. The axillary dissection confirmed a metastatic deposit in 1 out of 22 lymph nodes. At 6 months a satellite nodule arose between the resection scar and the axilla histopathologically demonstrating a cellular spindle cell nodule at the dermis subcutaneous junction with large, blood-filled pseudovascular spaces lined by histiocytes. The periphery of the lesion showed collagen trapping without a lymphoplasmacytic infiltrate. The lesional cells were diffusely positive for CD10 and focally for CD68 and Illumina RNA fusion panel sequencing was negative. Herein we present this case of metastatic aneurysmal fibrous histiocytoma with review of the literature and discussion of biology, cytogenetic alterations, and differential diagnosis.
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MESH Headings
- Adult
- Antigens, CD/metabolism
- Antigens, Differentiation, Myelomonocytic/metabolism
- Child, Preschool
- Diagnosis, Differential
- Female
- Genomics/methods
- Histiocytoma, Benign Fibrous/diagnosis
- Histiocytoma, Benign Fibrous/metabolism
- Histiocytoma, Benign Fibrous/surgery
- Histiocytoma, Malignant Fibrous/diagnosis
- Histiocytoma, Malignant Fibrous/metabolism
- Histiocytoma, Malignant Fibrous/surgery
- Humans
- Lymphatic Metastasis/pathology
- Neoplasm Recurrence, Local/pathology
- Neprilysin/metabolism
- Skin Neoplasms/pathology
- Skin Neoplasms/surgery
- Soft Tissue Neoplasms/pathology
- Soft Tissue Neoplasms/surgery
- Young Adult
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Affiliation(s)
- Kimberly A Wood
- University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Alexandra M Easson
- Department of Surgical Oncology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Danny Ghazarian
- University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Zaid Saeed Kamil
- University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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