Vulvoperineal Angiomyofibroblastoma in A Postmenopausal Woman: A Case Report

Abstract

Introduction: Angiomyofibroblastoma is a rare benign mesenchymal neoplasm of the lower genital tract, described mainly in women of reproductive age. Its nonspecific clinical presentation and its similarity to other benign or locally aggressive vulvar lesions, such as aggressive angiomyxoma, may complicate the initial diagnosis. Early recognition of this entity is essential to avoid unnecessarily aggressive surgical treatments and to ensure appropriate management.

Case Report: We present the case of a 51-year-old woman who attended a gynecological consultation due to a vulvar foreign-body sensation of approximately one year of evolution, characterized by slow growth and absence of pain. Physical examination revealed a well-circumscribed mass located in the right labium majus, near the urethral meatus, without signs of inflammation or inguinal lymphadenopathy. Soft-tissue ultrasound showed a well-defined hypoechoic mass without significant Doppler flow. Surgical management was performed through complete excision of the lesion with primary closure, without complications. Histopathological examination revealed a well-circumscribed tumor composed of alternating hypercellular and hypocellular areas, abundant capillary vascularity, and minimal mitotic activity. Immunohistochemical analysis showed positivity for vimentin and hormone receptors, confirming the diagnosis of angiomyofibroblastoma. Surgical margins were negative. The postoperative course was favorable, and no recurrence was documented during clinical and imaging follow-up.

Conclusion: Vulvar angiomyofibroblastoma is a rare entity that should be considered in the differential diagnosis of vulvar masses. Definitive diagnosis is established through histopathological evaluation, and complete surgical excision represents a curative treatment with an excellent prognosis.