Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2015

Open Access 01-12-2015 | Case report

Ultrasound plays a key role in imaging and management of genital angiomyofibroblastoma: a case report

Authors: Benjamin Wolf, Lars-Christian Horn, Romy Handzel, Jens Einenkel

Published in: Journal of Medical Case Reports | Issue 1/2015

Login to get access

Abstract

Introduction

Angiomyofibroblastoma is a benign, rare mesenchymal tumor arising from the genital tract of both men and women and was first described by Fletcher and colleagues in 1992. The tumor needs to be distinguished from other, similar lesions, such as deep and superficial aggressive angiomyxoma and cellular angiofibroma, because aggressive angiomyxoma demands much more extensive treatment. The vast majority of angiomyofibroblastomas arise from the vulva and appear as solid cystic masses on ultrasound images.

Case presentation

We report a case of a 35-year-old Caucasian woman with an angiomyofibroblastoma arising from the vagina. She presented with a painless mass of about 5cm in diameter that had a rather homogeneous, hypoechoic appearance on ultrasound images. The patient underwent surgical resection of the mass, which was subsequently diagnosed as angiomyofibroblastoma. We present sonographic and magnetic resonance imaging findings, intraoperative and histologic images, and a thorough review of the literature.

Conclusions

In our opinion, ultrasonography is the most valuable tool to establish a preoperative diagnosis of this tumor entity, differentiate it from other lesions of the female genital tract, and plan surgery accordingly. Even though it is a rare tumor, gynecologists should be able to recognize it and to differentiate it from other tumor entities that demand more aggressive treatment. We describe a different sonographic appearance of this tumor than previously reported.
Appendix
Available only for authorised users
Literature
1.
go back to reference Fletcher CD, Tsang WY, Fisher C, Lee KC, Chan JK. Angiomyofibroblastoma of the vulva: a benign neoplasm distinct from aggressive angiomyxoma. Am J Surg Pathol. 1992;16:373–82.CrossRefPubMed Fletcher CD, Tsang WY, Fisher C, Lee KC, Chan JK. Angiomyofibroblastoma of the vulva: a benign neoplasm distinct from aggressive angiomyxoma. Am J Surg Pathol. 1992;16:373–82.CrossRefPubMed
2.
go back to reference Poljak NK, Kljajić Z, Petricević J, Forempoher G, Simunić MM, Colović Z, et al. Polypoid angiomyofibroblastoma tumor of nasal cavity: case report. Coll Antropol. 2013;37:301–4.PubMed Poljak NK, Kljajić Z, Petricević J, Forempoher G, Simunić MM, Colović Z, et al. Polypoid angiomyofibroblastoma tumor of nasal cavity: case report. Coll Antropol. 2013;37:301–4.PubMed
4.
go back to reference Fetsch JF, Laskin WB, Lefkowitz M, Kindblom LG, Meis-Kindblom JM. Aggressive angiomyxoma: a clinicopathologic study of 29 female patients. Cancer. 1996;78:79–90.CrossRefPubMed Fetsch JF, Laskin WB, Lefkowitz M, Kindblom LG, Meis-Kindblom JM. Aggressive angiomyxoma: a clinicopathologic study of 29 female patients. Cancer. 1996;78:79–90.CrossRefPubMed
5.
go back to reference Chan YM, Hon E, Ngai SW, Ng TY, Wong LC, Chan IM. Aggressive angiomyxoma in females: is radical resection the only option? Acta Obstet Gynecol Scand. 2000;79:216–20.CrossRefPubMed Chan YM, Hon E, Ngai SW, Ng TY, Wong LC, Chan IM. Aggressive angiomyxoma in females: is radical resection the only option? Acta Obstet Gynecol Scand. 2000;79:216–20.CrossRefPubMed
6.
go back to reference Goodlad JR, Fletcher CD. Recent developments in soft tissue tumors. Histopathology. 1995;27:103–20.CrossRefPubMed Goodlad JR, Fletcher CD. Recent developments in soft tissue tumors. Histopathology. 1995;27:103–20.CrossRefPubMed
7.
go back to reference Magro G, Righi A, Casorzo L, Antonietta T, Salvatorelli L, Kacerovská D, et al. Mammary and vaginal myofibroblastomas are genetically related lesions: fluorescence in situ hybridization analysis shows deletion of 13q14 region. Hum Pathol. 2012;43:1887–93.CrossRefPubMed Magro G, Righi A, Casorzo L, Antonietta T, Salvatorelli L, Kacerovská D, et al. Mammary and vaginal myofibroblastomas are genetically related lesions: fluorescence in situ hybridization analysis shows deletion of 13q14 region. Hum Pathol. 2012;43:1887–93.CrossRefPubMed
8.
go back to reference Nielsen GP, Young RH, Dickersin GR, Rosenberg AE. Angiomyofibroblastoma of the vulva with sarcomatous transformation (“angiomyofibrosarcoma”). Am J Surg Pathol. 1997;21:1104–8.CrossRefPubMed Nielsen GP, Young RH, Dickersin GR, Rosenberg AE. Angiomyofibroblastoma of the vulva with sarcomatous transformation (“angiomyofibrosarcoma”). Am J Surg Pathol. 1997;21:1104–8.CrossRefPubMed
9.
go back to reference Laiyemo R, Disu S, Vijaya G, Wise B. Post-menopausal vaginal angiomyofibroblastoma: a case report. Arch Gynecol Obstet. 2005;273:129–30.CrossRefPubMed Laiyemo R, Disu S, Vijaya G, Wise B. Post-menopausal vaginal angiomyofibroblastoma: a case report. Arch Gynecol Obstet. 2005;273:129–30.CrossRefPubMed
10.
go back to reference Kavak ZN, Başgül A, Eren F, Ceyhan N. Angiomyofibroblastoma of the vulva: a rare but distinct entity. Acta Obstet Gynecol Scand. 2000;79:612–3.CrossRefPubMed Kavak ZN, Başgül A, Eren F, Ceyhan N. Angiomyofibroblastoma of the vulva: a rare but distinct entity. Acta Obstet Gynecol Scand. 2000;79:612–3.CrossRefPubMed
11.
go back to reference Banerjee K, Datta Gupta S, Mathur SR. Vaginal angiomyofibroblastoma. Arch Gynecol Obstet. 2004;270:124–5.CrossRefPubMed Banerjee K, Datta Gupta S, Mathur SR. Vaginal angiomyofibroblastoma. Arch Gynecol Obstet. 2004;270:124–5.CrossRefPubMed
12.
go back to reference Kim SW, Lee J, Han JK, Jeon S. Angiomyofibroblastoma of the vulva: sonographic and computed tomographic findings with pathologic correlation. J Ultrasound Med. 2009;28:1417–20.PubMed Kim SW, Lee J, Han JK, Jeon S. Angiomyofibroblastoma of the vulva: sonographic and computed tomographic findings with pathologic correlation. J Ultrasound Med. 2009;28:1417–20.PubMed
13.
go back to reference Wang X, Yang H, Zhang H, Shi T, Ren W. Transvaginal sonographic features of perineal masses in the female lower urogenital tract: a retrospective study of 71 patients. Ultrasound Obstet Gynecol. 2014;43:702–10.CrossRefPubMed Wang X, Yang H, Zhang H, Shi T, Ren W. Transvaginal sonographic features of perineal masses in the female lower urogenital tract: a retrospective study of 71 patients. Ultrasound Obstet Gynecol. 2014;43:702–10.CrossRefPubMed
14.
go back to reference Lee H, Jang K, Park H, Hwang SH, Park SY, Choi KH, et al. Angiomyofibroblastoma of the vagina in a breast cancer patient. Pathology. 2008;40:534–6.CrossRefPubMed Lee H, Jang K, Park H, Hwang SH, Park SY, Choi KH, et al. Angiomyofibroblastoma of the vagina in a breast cancer patient. Pathology. 2008;40:534–6.CrossRefPubMed
15.
go back to reference Varras M, Akrivis C, Demou A, Kitsiou E, Antoniou N. Angiomyofibroblastoma of the vagina in a postmenopausal breast cancer patient treated with tamoxifen: clinicopathologic analysis of a case and review of the literature. Int J Gynecol Cancer. 2006;16:581–5.CrossRefPubMed Varras M, Akrivis C, Demou A, Kitsiou E, Antoniou N. Angiomyofibroblastoma of the vagina in a postmenopausal breast cancer patient treated with tamoxifen: clinicopathologic analysis of a case and review of the literature. Int J Gynecol Cancer. 2006;16:581–5.CrossRefPubMed
16.
go back to reference Alameda F, Munné A, Baró T, Iglesias M, Condom E, Lloreta-Trull J, et al. Vulvar angiomyxoma, aggressive angiomyxoma, and angiomyofibroblastoma: an immunohistochemical and ultrastructural study. Ultrastruct Pathol. 2006;30:193–205.CrossRefPubMed Alameda F, Munné A, Baró T, Iglesias M, Condom E, Lloreta-Trull J, et al. Vulvar angiomyxoma, aggressive angiomyxoma, and angiomyofibroblastoma: an immunohistochemical and ultrastructural study. Ultrastruct Pathol. 2006;30:193–205.CrossRefPubMed
Metadata
Title
Ultrasound plays a key role in imaging and management of genital angiomyofibroblastoma: a case report
Authors
Benjamin Wolf
Lars-Christian Horn
Romy Handzel
Jens Einenkel
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2015
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-015-0715-4

Other articles of this Issue 1/2015

Journal of Medical Case Reports 1/2015 Go to the issue