Superficial Angiomyxoma of the Vulva in a Postmenopausal Woman: A Case Report and Review of Literature

Abstract

Superficial angiomyxomas (SAMs) are rare benign cutaneous tumors that involve the subcutaneous layer. They are commonly located in the trunk, lower limbs and head or neck of women of reproductive age. SAMs in the vulva of postmenopausal women are especially rare case. Herein, we report a vulvar SAM in a postmenopausal 60-year-old woman. The patient presented with a palpable cutaneous mass in the right labium majora that had appeared 3 months earlier. The mass was slow growing and approximately 5 cm in size and resembled a soft tissue malignancy. It appeared as a well-defined multilocular cystic mass in magnetic resonance images. The preoperative diagnosis was a benign cystic lesion such as an epidermoid cyst. Grossly, the completely excised mass was 6 × 5 cm in size and well circumscribed with a multilocular outer surface, a yellowish-gray gelatinous cut surface, and a smooth rubbery inner surface. Histologic review revealed that the mass contained small to moderate amount of cellular angiomyxoid nodules and bland-looking spindle-shaped to ovoid cells without atypia. Neutrophil infiltration, which is a diagnostic feature of SAMs, was observed. Immunohistochemistry showed expression of CD34, but not of estrogen receptors, progesterone receptors, or desmin in the SAM. The patient has been followed up for 12 months without recurrence.

Sonographic findings in superficial angiomyxoma of the vulva in a perimenopausal female

“…[2] As of 2016, fewer than 20 cases of SAM occurring in the female vulva had been reported in the English literature. [68] SAM is observed at all ages but occurs primarily in middle-aged patients mainly between the ages of 20 and 40 years old and is slightly more frequent in males than females. [5]…”

“…The pathogenesis of the disease is unknown, but it is characterized by a high concentration of small, thin-walled blood vessels and a mucous-like stroma. [6] SAM clinically manifests as painless masses that are visible to the naked eye; these masses exhibit slow growth and occur in many parts of the body but mainly in the head, neck, limbs, and trunk. However, the tumors can also occur in the external genitalia.…”

“…Most of the tumors have no obvious blood flow signal, but small amounts of blood flow signal have been observed in a few masses. [610] The abundant blood flow associated with SAM can therefore be identified and diagnosed. Differential diagnosis of vascular fibroblastoma, superficial fibroblastoma, or low mucous spindle cell lipoma should be made in cases occurring in the inguinal region.…”

“…As of 2016, fewer than 20 cases of SAM occurring in the vulva had been reported in the English literature, and no case in the English literature had described an SAM that occurred in the vulva of a perimenopausal female. [6] Here, we describe such a case. Surgical resection is the main treatment method for SAM.…”

A Case of Granular Cell Tumor of the Clitoris in a Postmenopausal Woman

“…This disease requires differentiation from all benign diseases of the external genitalia, especially angiomyxoma, which may occur after menopause. 12 There are many recent studies on the association between female disease and Jun activation-domain binding protein 1 (Jab1) and p27 kip1 , it would be helpful to do the test in the above disease. 13 Treatment is complete resection including margin and recurrence is common.…”