Rare Tumor Spotlight Giant Cellular Angiofibroma of the Vulva in a Postmenopausal Woman

Introduction

Cellular angiofibroma is a rare, benign tumor often misdiagnosed due to its subtle growth and location. This unique case from Portugal details a postmenopausal woman with a massive vulvar mass that developed over a decade, ultimately diagnosed as giant cellular angiofibromaa condition with limited recurrence potential if properly treated.

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Clinical Backgroun

• Patient: 76-year-old postmenopausal woman
• Presentation: Progressive, painless vulvar swelling for 10 years
• Size at removal: 7×4.5×4 cm
• Location: Right labia majora, extending into vulva
• Imaging: MRI showed a lobulated, exophytic soft tissue mass
• Diagnosis: Giant cellular angiofibroma (confirmed histologically)

The for the complete clinical case is https://doi.com/10.29328/journal.cjog.1001016

Key Clinical Observations

• The mass was pedunculated, solid, and painless.
• MRI imaging helped distinguish it from other benign vulvar conditions.
• The tumor was multilobulated and lipomatous, with no signs of malignancy.
• Histology revealed angiomatoid vascular proliferation and fibroadipose stroma.
• Hormone receptor positivity suggested estrogen/progesterone-driven growth.

Surgical Management and Outcome

• Complete surgical excision was performed, including the tumor capsule.
• The postoperative course was uneventful.
• No recurrence was observed during 12 months of follow-up.

Surgical removal remains the standard approach, ensuring complete excision and minimizing recurrence, consistent with other reported cases in literature.

Differential Diagnosis and Imaging Insights

• Differential considerations include:
  • Spindle cell lipoma
  • Angiomyofibroblastoma
  • Aggressive angiomyxoma
  • Smooth muscle tumors
• MRIproved critical in surgical planning, helping assess tumor origin, vascularity, and encapsulation.

As per the American College of Obstetricians and Gynecologists (ACOG), imaging plays a pivotal role in accurately diagnosing pelvic masses, especially those mimicking Bartholin cysts or lipomatous tumors.

Hormonal Influence and Histological Features

• Tumors consistently expressed estrogen and progesterone receptors.
• Typical histology includes fusiform cells and prominent vascular structures.
• The cellular architecture supports benign nature unless atypia or sarcomatous transformation is present.

These characteristics differentiate cellular angiofibroma from other vulvar soft tissue tumors and highlight the importance of histopathological evaluation.

Related Readings and Resources

• Learn more about rare benign vulvar tumors on our Obstetrics and Gynecology Journal resource hub.
• Explore our article series on vulvovaginal pathology and postmenopausal health conditions.

A detailed analysis of this case can be found in our main journal article.

Conclusion and Clinical Relevance

This case emphasizes the importance of considering cellular angiofibroma in the differential diagnosis of long-standing vulvar masses in elderly women. Timely MRI evaluation, accurate histological examination, and appropriate surgical planning can result in complete recovery without recurrence.

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