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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2022; 83(03): e110-e118
DOI: 10.1055/s-0042-1754320
Case Report

Operative Technique: Angiomatoid Fibrous Histiocytoma—Unique Case and Management

David J. Mazur-Hart
1   Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Brannan E. O'Neill
1   Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Brandi W. Pang
1   Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Melanie H. Hakar
2   Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, Oregon, United States
,
Matthew D. Wood
2   Department of Pathology and Laboratory Medicine, Oregon Health and Science University, Portland, Oregon, United States
,
Sachin Gupta
3   Division of Otology/Neurotology/Skull Base Surgery, Department of Otolaryngology—Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Christina M. Sayama
1   Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Jesse J. Liu
1   Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, United States
,
Aclan Dogan
1   Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon, United States
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Abstract

Objective We describe the first jugular foramen angiomatoid fibrous histiocytoma (AFH) case and the first treatment with preoperative endovascular embolization. AFH is a rare intracranial neoplasm, primarily found in pediatric patient extremities. With an increase in AFH awareness and a well-described genetic profile, intracranial prevalence has also subsequently increased.

Study Design We compare this case to previously reported cases using PubMed/Medline literature search, which was performed using the algorithm [“intracranial” AND “angiomatoid fibrous histiocytoma”] through December 2020 (23 manuscripts with 46 unique cases).

Patient An 8-year-old female presented with failure to thrive and right-sided hearing loss. Work-up revealed an absence of right-sided serviceable hearing and a large jugular foramen mass. Angiogram revealed primary arterial supply from the posterior branch of the ascending pharyngeal artery, which was preoperatively embolized.

Intervention Gross total resection was performed via a translabyrinthine approach.

Conclusion The case presented is unique; the first reported AFH at the jugular foramen and the first reported case utilizing preoperative embolization. Preoperative embolization is a relatively safe technique that can improve the surgeon's ability to perform a maximally safe resection, which may decrease the need for adjuvant radiation in rare skull base tumors in young patients.

Keywords

angiomatoid fibrous histiocytoma - jugular foramen - preoperative embolization - translabyrinthine approach


Publication History

Received: 22 December 2021

Accepted: 11 May 2022

Article published online:
20 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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