Angiographic Embolization followed by Excision of Large Cellular Angiofibroma of the Vulva

Abstract

Introduction: Cellular angiofibroma is a rare benign mesenchymal tumor, occurring almost exclusively in the superficial soft tissues of the genital region. Some of these lesions presents as large, hypervascularized masses. There are no reports in the literature to date on the challenges of resection of hypervascularized vulvar masses, or of hypervascularized cellular angiofibroma.Materials and methods: We describe a case of a cellular angiofibroma of the vulva and the surgical approach with tumoral vessel embolization and posterior resection.Case: A 47-year-old women was referred to vulvar pathology section of Italian Hospital of Buenos Aires for evaluation of left vulvar mass. A pelvic angiography was performed 5 days prior to surgery. It showed a hypervascularized formation at the level of the left vulva at the expense mainly of branches of the left internal pudendal artery. A complete resection was performed afterwards at our institution. The histopathological diagnosis was compatible with cellular angiofibroma.Conclusion: We consider that surgical planning is essential and has to be performed with a multidisciplinary approach. Angiographic embolization should be taken into account as a valid resource when planning a surgery with a high risk of blood loss in order to decrease morbidity.