{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T18:34:09Z","timestamp":1772130849569,"version":"3.50.1"},"reference-count":41,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,4,4]],"date-time":"2021-04-04T00:00:00Z","timestamp":1617494400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatopathology"],"abstract":"<jats:p>Pleomorphic hyalinizing angiectatic tumor (PHAT) is a very rare entity of soft tissue considered a \u201cneoplasm of uncertain behaviour of connective or other soft tissue\u201d by the World Health Organization (2020). It develops in subcutaneous tissue of the lower extremities, more frequently in the region of the ankle and foot, and rarely as a deep-seated soft tissue mass in locations such as the perineum, buttock, arms, head and neck, and viscera. Although inconsistent cytogenetic data have been reported on PHAT so far, there are potential morphological and genetic overlaps with hemosiderotic fibrolipomatous tumor (HFLT) and myxoinflammatory fibroblastic sarcoma (MIFS). Here we report a case of PHAT at the level of the upper third of the right thigh in a 48-year-old patient and we also focus on the differential diagnoses of these entities and conduct a literature review of reported cases.<\/jats:p>","DOI":"10.3390\/dermatopathology8020015","type":"journal-article","created":{"date-parts":[[2021,4,5]],"date-time":"2021-04-05T11:48:29Z","timestamp":1617623309000},"page":"97-102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Pleomorphic Hyalinizing Angiectatic Tumor (PHAT): Review of the Literature with Case Presentation"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0325-4316","authenticated-orcid":false,"given":"Gerardo","family":"Cazzato","sequence":"first","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Colagrande","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonietta","family":"Cimmino","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0860-3044","authenticated-orcid":false,"given":"Teresa","family":"Lettini","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Teresa","family":"Savino","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Martella","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4792-3545","authenticated-orcid":false,"given":"Giuseppe","family":"Ingravallo","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4335-4776","authenticated-orcid":false,"given":"Leonardo","family":"Resta","sequence":"additional","affiliation":[{"name":"Department of Emergency and Organ Transplantation\u2014Section of Pathology, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/00000478-199601000-00002","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: A low-grade neoplasm resembling neurilemoma","volume":"20","author":"Smith","year":"1996","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_2","unstructured":"Soft Tissue and Bone Tumours (2020). WHO Classification of Tumours, World Health Organization. [5th ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1016\/j.prp.2014.04.016","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: Case report with unusual ganglion-like cells and review of the literature","volume":"210","author":"Changchien","year":"2014","journal-title":"Pathol. Res. Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"E45","DOI":"10.1177\/000313481207800128","article-title":"Pleomorphic hyalinizing angiectatic tumor in the inguinal area: A potential diagnostic pitfall","volume":"78","author":"Choong","year":"2012","journal-title":"Am. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1016\/S0929-6646(10)60100-3","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts","volume":"109","author":"Peng","year":"2010","journal-title":"J. Formos. Med. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"784","DOI":"10.1111\/j.1440-1827.1997.tb04458.x","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts","volume":"47","author":"Fukunaga","year":"1997","journal-title":"Pathol. Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1111\/j.1600-0560.1997.tb00807.x","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: Immunohistochemical case study shows cellular composition by CD34+ fibroblasts and factor XIIIa+ dendrophages","volume":"24","author":"Silverman","year":"1997","journal-title":"J. Cutan. Pathol."},{"key":"ref_8","first-page":"531","article-title":"Pleomorphic hyalinizing angiectasic soft-tissue tumor: Description of a case","volume":"89","author":"Gallo","year":"1997","journal-title":"Pathologica"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"423","DOI":"10.5858\/2000-124-0423-PHATOS","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: Immunohistochemical study including the expression of vascular endothelial growth factor","volume":"124","author":"Groisman","year":"2000","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1046\/j.1440-1827.2002.01406.x","article-title":"Pleomorphic hyalinizing angi-ectatic tumor of soft parts: A case report and literature review","volume":"52","author":"Matsumoto","year":"2002","journal-title":"Pathol. Int."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E107","DOI":"10.5858\/2003-127-e107-PQ","article-title":"A 49-year-old woman with a left axillary mass","volume":"127","author":"Iwamoto","year":"2003","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1097\/01.pas.0000141406.02581.fb","article-title":"Pleomorphic hyalinizing angiectatic tumor: Analysis of 41 cases supporting evolution from a distinctive precursor lesion","volume":"28","author":"Folpe","year":"2004","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1111\/j.1346-8138.2004.tb00696.x","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: Report of a case and review of the literature","volume":"31","author":"Fujiwara","year":"2004","journal-title":"J. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/S0039-6060(03)00385-4","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts","volume":"137","author":"Lee","year":"2004","journal-title":"Surgery"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1111\/j.1440-1827.2006.01955.x","article-title":"Hemosiderotic fibrohistiocytic lipomatous lesion: Early pleomorphic hyalinizing angiectatic tumor?","volume":"56","author":"Luzar","year":"2006","journal-title":"Pathol. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1080\/019131290969442","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: Ultrastructural analysis of a case with original features","volume":"10","author":"Capovilla","year":"2006","journal-title":"Ultrastruct. Pathol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.0303-6987.2006.00416.x","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts: Case report and literature review","volume":"33","author":"Mehregan","year":"2006","journal-title":"J. Cutan Pathol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1111\/j.1440-1827.2007.02094.x","article-title":"Pleomorphic hyalinizing angiectatic tumor with a sarcomatous component recurring as high-grade myxofibrosarcoma","volume":"57","author":"Kazakov","year":"2007","journal-title":"Pathol. Int."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1097\/00029330-200705020-00005","article-title":"Clinicopathologic features of pleomorphic hyalinizing angiectatic tumor of soft parts","volume":"120","author":"Ke","year":"2007","journal-title":"Chin. Med. J."},{"key":"ref_20","first-page":"544","article-title":"Pleomorphic hyalinizing angiectatic tumour of soft parts: A case report and review of the literature","volume":"56","author":"Jaggon","year":"2007","journal-title":"West Indian Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.prp.2008.07.010","article-title":"Pleomorphic hyalinizing angiectatic tumor of the male breast: A heretofore unreported occurrence","volume":"205","author":"Tallarigo","year":"2009","journal-title":"Pathol. Res. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1002\/dc.21403","article-title":"Pleomorphic hyalinizing angi-ectatic tumor: Cytomorphologic features on fine-needle aspiration","volume":"39","author":"Ali","year":"2011","journal-title":"Diagn. Cytopathol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1007\/s12262-010-0099-z","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts involving the upper limb","volume":"72","author":"Parameshwarappa","year":"2010","journal-title":"Indian J. Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1097\/PAI.0b013e31821a24ab","article-title":"Pleomorphic hyalinizing angiectatic tumor: A report of 3 new cases, 1 with sarcomatous myxofibro- sarcoma component and another with unreported soft tissue palpebral location","volume":"20","author":"Illueca","year":"2012","journal-title":"Appl. Immunohistochem. Mol. Morphol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s00256-012-1443-0","article-title":"Pleomorphic hyalinizing angiectatic tumor: Imaging findings","volume":"41","author":"Subhawong","year":"2012","journal-title":"Skeletal. Radiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.humpath.2011.02.023","article-title":"Complex analysis of a recurrent pleomorphic hyalinizing angiectatic tumor of soft parts","volume":"43","author":"Wei","year":"2012","journal-title":"Hum. Pathol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.anndiagpath.2011.03.010","article-title":"Pleomorphic hyalinizing angiectatic tumor of renal hilum","volume":"16","author":"Idrees","year":"2012","journal-title":"Ann. Diagn. Pathol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"321","DOI":"10.4103\/0377-4929.120414","article-title":"Pleomorphic hyalinizing angiectatic tumor exhibiting intricate branching vasculature: An interesting pattern in a rare tumor","volume":"56","author":"Rekhi","year":"2013","journal-title":"Indian J. Pathol. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1007\/s11604-012-0157-5","article-title":"CT findings of pleomorphic hyalinizing angiectatic tumor (PHAT) of soft parts of the neck","volume":"31","author":"Kuang","year":"2013","journal-title":"Jpn. J. Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1111\/ijd.12003","article-title":"Spontaneous bruising overlying a subcutaneous swelling: Pleomorphic hyalinizing angiectatic tumor, a relatively new entity of intermediate malignancy","volume":"54","author":"Felton","year":"2015","journal-title":"Int. J. Dermatol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1159\/000443319","article-title":"Cytologic and histologic features of pleomorphic undifferentiated sarcoma arising in a hybrid hemosiderotic fibrolipomatous tumor and pleomorphic hyalinizing angiectatic tumor: Report of an unusual case with a literature review","volume":"59","author":"Morency","year":"2015","journal-title":"Acta Cytol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1016\/j.surg.2015.04.033","article-title":"Large pleomorphic hyalinizing angiectatic tumor of the forearm: A multidisciplinary perspective","volume":"159","author":"Brazio","year":"2016","journal-title":"Surgery"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"NP20","DOI":"10.1177\/1558944715627275","article-title":"Pleomorphic Hyalinizing Angiectatic Tumor Arising in the Hand: A Case Report","volume":"11","author":"Kane","year":"2016","journal-title":"Hand"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Chu, Z.G., Liu, M.Q., Zhu, Z.Y., Lv, F.J., and Ouyang, Y. (2016). Pelvic retroperitoneal pleomorphic hyalinizing angiectatic tumor (PHAT) of soft tissue: A case report. BMC Med. Imaging, 16.","DOI":"10.1186\/s12880-016-0130-3"},{"key":"ref_35","first-page":"ED15","article-title":"Pleomorphic Hyalinizing Angiectatic Tumour: A Rare Case Report and Discussion of Differential Diagnosis","volume":"11","author":"Chalmeti","year":"2017","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.prp.2016.11.005","article-title":"Clinical implications of a rare renal entity: Pleomorphic Hyalinizing Angiectatic Tumor (PHAT)","volume":"213","author":"Serretta","year":"2017","journal-title":"Pathol. Res. Pract."},{"key":"ref_37","first-page":"4720","article-title":"Imaging and histological appearance of pleomorphic hyalinizing angiectatic tumors: A case series and literature review","volume":"15","author":"Jaramillo","year":"2018","journal-title":"Oncol. Lett."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"619","DOI":"10.4103\/ijdvl.IJDVL_693_17","article-title":"Pleomorphic hyalinizing angiectatic tumor of soft parts with unusual lipoma-like clinical morphology","volume":"84","author":"Szep","year":"2018","journal-title":"Indian J. Dermatol. Venereol. Leprol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e2019097","DOI":"10.4322\/acr.2019.097","article-title":"Pleomorphic hyalinizing angiectatic tumor of the mesorectum: A rare case and review of literature","volume":"9","author":"Balasubiramaniyan","year":"2019","journal-title":"Autops. Case Rep."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.jormas.2019.02.021","article-title":"Pleomorphic hyalinizing angiectatic tumor in the oral cavity: Report of a rare case","volume":"121","author":"Deniz","year":"2020","journal-title":"J. Stomatol. Oral Maxillofac. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s12306-018-0532-1","article-title":"Treatment modalities and outcomes of pleomorphic hyalinizing angiectatic tumor: A systematic review of the literature","volume":"102","author":"Rush","year":"2018","journal-title":"Musculoskelet. Surg."}],"container-title":["Dermatopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2296-3529\/8\/2\/15\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:26:16Z","timestamp":1760361976000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2296-3529\/8\/2\/15"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,4]]},"references-count":41,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["dermatopathology8020015"],"URL":"https:\/\/doi.org\/10.3390\/dermatopathology8020015","relation":{},"ISSN":["2296-3529"],"issn-type":[{"value":"2296-3529","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,4]]}}}