Cervicovaginal cellular angiofibroma

Abstract

Cellular angiofibroma is a rare type of benign mesenchymal tumour that arises mostly in middle-aged women. It needs to be distinguished from other neoplasms and has a predilection for the vulvovaginal region. To our knowledge, this is the first case of a cervical cellular angiofibroma. A 34-year-old nulligravid woman was referred with a large mass bulging in the fornix posterior. Ultrasound scanning and MRI showed a large solid mass projecting in the pouch of Douglas. Laparoscopic surgical excision was performed. Histopathological examination showed a well-demarcated, unencapsulated tumour, consisting of short fascicles of spindle cells in-between thick-walled medium-sized vessels. On immunohistochemistry, there was strong reactivity with antibodies against CD34 and oestrogen receptor. Angiofibromas are benign mesenchymal tumours mostly occurring in middle-aged women. They can cause abnormal swelling and uterine bleeding and need to be distinguished from other (malignant) neoplasms.

Cellular angiofibroma of the vagina: A case report and literature review

“…In the published literature, most articles pertaining to vaginal CAF are case reports or small case series. [14,17–22] Our patient had a well-defined solid and round mass with a maximum length of 2.5 cm, which was consistent with the previously reported cases.…”

Management of Vulvovaginal Cellular Angiofibroma: A Single-Center Experience

“…Cellular angiofibroma usually arise in the superficial soft tissues of the female vulva ( 2 ). In 2020, cervicovaginal cellular angiofibroma, a large mass bulging in the posterior fornix, was first published ( 5 ). Our study reported vaginal stump cellular angiofibroma for the first time.…”

Case Report : Cervical Cellular Angiofibroma

“…In this case, it was found that the distal part of the tumor gave a necrotic appearance, while in the case of uterine myoma, degeneration due to reduced vascularity would give a necrotic appearance in the center of the tumor due to more vascularization at the peripheral, while cellular angiofibroma consisted of more vascular tissue. 3,5,6 In addition to histopathological examination, the histochemical examination can also be performed to confirm the diagnosis of cellular angiofibroma by examining the expression of CD34 protein because research by Mulders et al found that 55% of cellular angiofibroma cases secrete CD34 and 50% have receptors for progesterone and estrogen. So, it is believed that the trigger for the occurrence of cellular angiofibroma can be caused by the influence of estrogen and progesterone hormone receptors, and the sudden transformation of the surrounding tissue is also believed to be the trigger for this tumor.…”

“…In women, this disease usually occurs in the vulvovaginal region, especially in the labia majora and vulva, while in men, it can be associated with testicular hydrocele, inguinal hernia, and the inguinoscrotal region. 1,2,3 Cellular angiofibroma is common in middle-aged women with an average age of 46 to 54 years. These tumors are reported to have initial characteristics of a small, asymptomatic, painless subcutaneous mass that develops slowly and usually takes 1 -2 years to show symptoms.…”

“…This condition leads to late diagnosis and worse prognosis. 3 On Pathological examination, the mass is usually small, around 2.7 cm in size, with clear boundaries and a rubbery gray-white solid surface. While histologically, it has well-defined uncapsulated characteristics consisting of fascicles cells surrounded by collagenous and spindle-shaped cells with medium-sized thick-walled blood vessels.…”