Giant cell angiofibroma misdiagnosed as a vascular malformation and treated with absolute alcohol for one year: a case report and review of the literature

World J Surg Oncol. 2014 Apr 24:12:117. doi: 10.1186/1477-7819-12-117.

Abstract

Purpose: To present the clinical, imaging, pathological and immunohistochemical features of giant cell angiofibroma (GCA).

Case presentation: In this paper we report an atypical case of a GCA extending from the parotid to the parapharyngeal space. The lesion was being treated as a vascular malformation for one year prior to surgical removal. We summarize the clinical manifestations, imaging, pathological and molecular features of this rare disease.After complete surgical removal of the tumor, immunohistochemical analysis revealed strong positivity for the mesenchymal markers vimentin, CD34, CD31 and CD99 in neoplastic cells. Tumor proliferation antigen marker Ki67 was partly positive (<5% of cells). Tumor cells were negative for muscle-specific actin, epithelial membrane antigen, smooth muscle actin, cytokeratin pan, S100, desmin, glial fibrillary acidic protein, myogenin, MyoD1 and F8. The morphological and immunohistochemical profile was consistent with the diagnosis of GCA.

Conclusion: GCA is a rare soft tissue tumor that can easily be misdiagnosed in the clinical preoperative setting. In view of the clinical, pathological and molecular features of the tumor, complete surgical removal is the current optimal treatment option, providing accurate diagnosis and low to minimal recurrence rate.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adult
  • Angiofibroma / diagnosis*
  • Angiofibroma / drug therapy
  • Angiofibroma / metabolism
  • Biomarkers, Tumor / metabolism
  • Central Nervous System Depressants / therapeutic use*
  • Diagnostic Errors
  • Ethanol / therapeutic use*
  • Giant Cells / drug effects
  • Giant Cells / metabolism
  • Giant Cells / pathology*
  • Humans
  • Immunoenzyme Techniques
  • Magnetic Resonance Imaging
  • Male
  • Prognosis
  • Vascular Malformations / diagnosis*
  • Vascular Malformations / drug therapy*
  • Vascular Malformations / metabolism

Substances

  • Biomarkers, Tumor
  • Central Nervous System Depressants
  • Ethanol