Angiomyofibroblastoma-like tumor (cellular angiofibroma) in the male inguinal region

Miyajima, Kimitaka; Hasegawa, Shuji; Oda, Yoshinao; Toyoshima, Satoshi; Tsuneyoshi, Masazumi; Motooka, Makoto; Matsumura, Yasuo; Ishioka, Hisakazu; Ōno, Minoru

doi:10.1007/s11604-006-0114-2

Cited by 21 publications

(25 citation statements)

References 24 publications

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“…10,11 Conversely, CAFs are definitively treated by simple excision and no clear recurrence has ever been noted. 6,12,13 Therefore, removal and clinical follow-up is an adequate long-term plan and our patient was still disease-free at the 9-month follow up.…”

Section: Discussionmentioning

confidence: 70%

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A large cellular angiofibroma of the male pelvis presenting with obstructive voiding: A case report and review of the literature

Emtage

Parker

Marcet

et al. 2013

CUAJ

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Cellular angiofibromas (CAF) are rare, benign soft-tissue tumours. The diagnosis of CAF is important given the heavy resemblance to other tumours. Herein, we describe a case of a rapidly growing, very large (13.5 cm) CAF located in the deep pelvis of a middleaged male who presented with difficulty voiding. IntroductionCellular angiofibromas (CAF) are rare, benign soft-tissue tumours first described by Nucci and colleagues in 1997. 1 CAF share pathological features of angiomyofibroblastoma and aggressive angiomyxoma (AAM), but do not fall into either category. The masses are well-circumscribed, typically less than 3.0 cm and show marked female predominance. In 1998, Laskin and colleagues reported 11 of these tumours in male genitalia, 2 and since then there have been only a few case reports. Most have been found in women, primarily in the vulva. [3][4][5] In males, most are found in the scrotum and inguinal region, averaging about 5 to 6 cm in size.2,3 The diagnosis of CAF is important given the heavy resemblance to other tumours, such as AAM, which is known to have a very high rate of local recurrence. 4 Herein, we describe the case of a rapidly growing, very large (13.5 cm) CAF located in the deep pelvis of a middle-aged male who presented with difficulty voiding. Case presentationA 58-year-old man initially presented with right groin/pelvic pain radiating down into his scrotum, as well as decreased urinary flow and decreased ejaculation. Due to refractory symptoms, a computed tomography (CT) scan of the abdomen and pelvis was done which showed a 7 × 7 × 5-cm mass to the right of the prostate extending down to the bulbar urethra. Prior attempts at both transurethral drainage and transperineal aspiration were unsuccessful and he was then referred to our clinic. A pelvic magnetic resonance imaging (MRI) revealed substantial growth; a 11-cm wellcircumscribed lesion abutting the rectum and displacing the urinary bladder and prostate proximally (Fig. 1, Fig. 2). Biopsies showed a benign stromal tumour of genitourinary origin. Resection was recommended via combined abdominal/perineal approach with colorectal surgery and urology.Exploratory laparotomy showed a large encapsulated mass occupying the entirety of the lower pelvis. The mass was dissected off of the prostate with relative ease, but was more difficult distally owing to dense adherence to a 3-cm portion on the anterior surface of the bulbar urethra. The mass was carefully freed from the rectum through the perineal incision. Ultimately, the intact mass in its entirety was removed with no evidence of residual disease. The specimen was sent to pathology and was read as a large benign spindle cell tumour mostly consistent with a CAF. Gross descriptionThis was an encapsulated, well-circumscribed mass with a thin fibrous capsule. It was elongated and measured 13.5 × 7.4 × 3.7 cm (Fig. 3). The mass felt rubbery and sectioning revealed a gelatinous, tan-pink to grey surface that was focally trabeculated. Microscopic descriptionThe mass consisted of loosely ar...

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Section: Discussionmentioning

confidence: 70%

“…6,12,13 Therefore, removal and clinical follow-up is an adequate long-term plan and our patient was still disease-free at the 9-month follow up.…”

Section: 2mentioning

confidence: 70%

A large cellular angiofibroma of the male pelvis presenting with obstructive voiding: A case report and review of the literature

Emtage

Parker

Marcet

et al. 2013

CUAJ

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“…No cases of metastatic disease or recurrence are described (8). AF arises mainly in inguino-scrotal region in men but is very rare in the testis; it originates from perivascular stem cells that differentiates into fatty and myofibroblastic cells (9); it is composed by prominent blood vessels, low cellularity with spindle cells (9) within collagenous stroma, without mitotic activity, necrosis, nuclear pleomorphisms. Testicular parenchyma is not remarkable inside the lesion and a vascular axis is described in the center.…”

Section: Discussionmentioning

confidence: 99%

Rare presentation of a testicular angiofibroma treated with testis sparing surgery

Leone

Fulvi

Sbrollini

et al. 2016

Arch Ital Urol Androl

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Introduction: Testicular benign tumors are very rare (< 5%). Testicular Angiofibroma (AF) is one of those, however the gold standard of treatment and follow-up is still unclear. Case report: A 47 years-old man with only one functioning testis was referred to our clinic for a palpable right testicular mass and atrophic contralateral testis. Patient underwent testis-sparing surgery with inguinal approach and intraoperative frozen sections examination with diagnosis of AF. Final histology confirmed AF. Post-operative follow-up was uneventful. Clinical and ultrasonographic follow-up was negative after 8 months. Conclusion: We report a conservative surgery in a patient with AF of the solitary testis. AF is a benign para-testicular fibrous neoplasm that could be misinterpreted as malignant tumor and treated with orchiectomy. Testis-sparing surgery is recommended in this case with intraoperative pathological examination. The excision of the mass is enough but in front of a possible recurrence a long follow-up is advisable.

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“…9,10 The heterogeneity on T2-weighted MRI is caused by a variable amount of spindle cells, collagenous stroma, and adipose tissue. As seen on T2-weighted MRI, nodular and curvilinear hypointense areas corresponding to abundant collagenous stroma within an angiomyofi broblastoma arising from posterior perivesical space were reported.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging findings of fibroepithelial polyp of the vulva: radiological-pathological correlation

et al. 2010

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We describe the magnetic resonance (MR) imaging findings in a 20-year-old woman with a fibroepithelial polyp of the vulva. Within the lesion, abundant fibrous tissue was visualized as stratiform hypointense areas on T2-weighted magnetic resonance imaging (MRI) scans. At the center of the attachment site, clustered fatty tissue was revealed as linear hyperintense areas on T1-weighted MRI. A mild degree of edematous stroma including less fibrosis and cellularity was demonstrated as hyperintense areas on T2-weighted MRI and hypointense areas on T1-weighted MRI. Although the MRI findings of fibroepithelial polyps of the vulva are often similar to those of aggressive angiomyxoma, angiomyofibroblastoma, and cellular angiofibroma, a fibroepithelial polyp should be considered when radiological images demonstrate the following features: stratiform hypointense areas surrounded by patchy hyperintense areas on T2-weighted MRI and hyperintense areas on T1-weighted MRI.

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Angiomyofibroblastoma-like tumor (cellular angiofibroma) in the male inguinal region

Cited by 21 publications

References 24 publications

A large cellular angiofibroma of the male pelvis presenting with obstructive voiding: A case report and review of the literature

A large cellular angiofibroma of the male pelvis presenting with obstructive voiding: A case report and review of the literature

Rare presentation of a testicular angiofibroma treated with testis sparing surgery

Magnetic resonance imaging findings of fibroepithelial polyp of the vulva: radiological-pathological correlation

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