A rare variant of a common neoplasm: A chest wall mass with vascular features

A 48-year-old male was referred to our skin cancer clinic with a 15-year history of a gradually enlarging, bleeding, tender 2 cm bluish nodule on his left upper chest. He had no significant medical history or systemic symptoms. Clinical examination revealed a solitary, tender nodule, and imaging suggested a vascular lesion. Histopathology confirmed aneurysmal fibrous histiocytoma (AFH), characterized by blood-filled spaces lacking endothelial lining, hemosiderin deposition, and inflammatory infiltrates. Immunohistochemically, the lesion expressed CD68 and factor XIIIa, differentiating it from vascular neoplasms. Complete excision reduces recurrence risk, but the patient deferred treatment. This case underscores the importance of histopathological analysis accurate diagnosis and management.