An angiomatoid fibrous histiocytoma over the left pre auricular region in a 13-year-old boy

Abstract

A 13-year-old boy presented to us for the evaluation of a slowly growing mass over the left preauricular region. Physical examination showed a nodular swelling, firm on palpation. The patient had no lymphadenopathy. The findings of magnetic resonance imaging (MRI) and vascular MRI led us to suspect a vascular growth. An incisional biopsy was performed and revealed an angiomatoid fibrous histiocytoma (AFH). Angiomatoid fibrous histiocytoma (AFH) is a rare tumor of the soft tissue with fibrohistiocytic and vascular differentiation that shows an intermediate malignancy grade, mainly occurs in patients younger than 20 years of age, and is usually localized on the extremities. Angiomatoid fibrous histiocytoma is considered to be a tumor of intermediate malignancy because of its less aggressive course in contrast to conventional malignant fibrous histiocytoma (MFH). Our case of AFH is peculiar because of its localization in the pre auricular region and because it appeared in a young patient. Surgical excision with maxillo-facial, chest-abdomen, and neck CT and prolonged follow-up is recommended because rare cases of metastasizing AFH have been reported.