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Giant thigh hemosiderotic/aneurysmal dermatofibroma: Case report with radiologic-pathologic correlation
Eva Manuela Pena-Burgos1, Carolina D'Angelo1, María Cristina Díez-Corral1
1Príncipe de Asturias University Hospital, Pathology Department, Spain.
Summary
Giant hemosiderotic/aneurysmal dermatofibroma (H/ADF) can mimic malignant tumors. This case highlights the importance of comprehensive imaging and histology for accurate diagnosis of these rare soft tissue neoplasms.
Area of Science:
- Dermatopathology
- Medical Imaging
- Oncology
Background:
- Hemosiderotic/aneurysmal dermatofibroma (H/ADF) is a rare variant of dermatofibroma.
- It can be mistaken for malignant soft tissue tumors, posing diagnostic challenges.
Observation:
- A case of a giant (7.6cm) subcutaneous H/ADF in a 53-year-old female thigh is presented.
- Spectral Doppler ultrasound revealed internal arterial and venous hypervascularity.
- MRI showed a distinct mass with specific signal characteristics on T1-WI, T2-WI, and fat-suppressed T2-WI.
Findings:
- Histopathology confirmed H/ADF with fusocellular proliferation, hemosiderin pigment, and endothelial-lacking pseudovascular spaces.
- Immunohistochemistry was positive for CD163, factor XIIIa, and CD10.
- Despite affected surgical margins, the patient showed no local relapse or distant metastasis.
Implications:
- Giant H/ADF requires careful clinical, radiological, and histopathological evaluation to differentiate from malignancies like melanoma, vascular lesions, or sarcomas.
- Accurate diagnosis is crucial for appropriate management and patient outcomes.
