Angiomatoid fibrous histiocytoma (AFH) is a rare, slow-growing soft tissue tumor with an intermediate biologic potential and uncertain line of differentiation, and minimal metastatic potential. AFH may mimic both the clinical, histological, and radiological findings of several tumors; therefore, it is frequently misdiagnosed.Three cases of AFH were included in this study. A six-year-old male and two females with an age of 12 and 17 years are presented. The primary locations were in the right shoulder (case 1), left medial proximal thigh (case 2), and left lateral knee (case 3). Two cases (cases 2&3) were presented with a painful mass. In the three patients, the masses were firm, mobile, and not attached to the skin.Magnetic resonance imaging (MRI) was done, illustrating unspecific findings to reach a diagnosis. Needle biopsies were performed in all patient, and the diagnosis of AFH was reached. All three patients underwent wide surgical excision of the tumor. Patients were followed up routinely every three to four months with imaging studies to rule out recurrence and metastasis, for a period of 15 months (case 1), 26 months (case 2), and 19 months (case 3), which all resulted negatively.
Melorheostosis is a very rare bone dysplasia, especially in the hand. Most cases were diagnosed incidentally, with the lower limbs being the most affected. This is the first Saudi woman with hand melorheostosis. A 33-year-old Saudi female had mild to moderate right-hand pain that started six years ago. Hand examination showed a full range of motion and full hand grip, and there was no tenderness upon palpation. Plain X-ray, unenhanced CT scan, and MRI of the hand showed an appearance resembling dripping candle wax as melorheostosis. The bone scan showed a nonvascular and nonacute lesion. An unenhanced CT scan demonstrated cortical and endosteal hyperostosis involving the proximal, middle, and distal third and fourth phalanges. Multisequential MRI of the hand demonstrated cortical hyperostosis involving the ulnar and radial aspect of the right fourth proximal, middle, and distal phalanges. Features in the X-ray, CT scan, bone scan, and MRI confirmed a diagnosis of melorheostosis with associated flexor tenosynovitis.
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