Overview
Angiofibroma of soft tissue (AFST) is a rare mesenchymal neoplasm characterized by fibroblastic and vascular components, typically presenting as a benign, slowly enlarging mass, most commonly in deep tissues of extremities but occasionally in superficial locations like the cheek or maxillary sinus 123.Diagnosis
Morphological Features: Prominent vasculature and infiltrative growth pattern 1.
Immunohistochemistry: Initially relied on for diagnosis, now complemented by molecular studies 1.
Molecular Studies: Emerging role in confirming diagnosis 1.
Site-Specific Considerations: Extranasopharyngeal localization, particularly in maxillary sinus, ethmoid sinus, and cheek, requires careful differentiation from other lesions 23.Management
Surgical Excision: Complete excision is curative with very low recurrence rates 1.
Preoperative Embolization: Recommended for cases requiring extensive resection to minimize blood loss, as seen in buccal cases 2.
No Specific Pharmacological Therapy: No drug classes or specific doses mentioned for treatment 123.Special Populations
Pediatrics: Juvenile angiofibroma can occur in adolescents, often originating from the maxillary sinus, with fibroblastic cells being predominant 3.
Comorbidities: No specific management adjustments noted for comorbidities in the provided abstracts 123.Key Recommendations
Confirm Diagnosis with Combined Morphology, Immunohistochemistry, and Molecular Studies (Evidence: Moderate 1).
Ensure Complete Surgical Excision for Optimal Outcomes (Evidence: Strong 1).
Consider Preoperative Embolization for Extensive Lesions to Facilitate Safe Resection (Evidence: Weak 2).References
1 Mindiola-Romero AE, Maloney N, Bridge JA, Korkolopoulou P, Sakellariou S, Linos K. A concise review of angiofibroma of soft tissue: A rare newly described entity that can be encountered by dermatopathologists. Journal of cutaneous pathology 2020. link
2 Dere H, Ozcan KM, Ergul G, Bahar S, Ozcan I, Kulacoglu S. Extranasopharyngeal angiofibroma of the cheek. The Journal of laryngology and otology 2006. link
3 Kitano M, Landini G, Mimura T. Juvenile angiofibroma of the maxillary sinus. A case report. International journal of oral and maxillofacial surgery 1992. link80225-5)