Angiomyofibroblastoma: Imaging and histopathology of a rare benign mesenchymal tumor

Angiomyofibroblastomas, aggressive angiomyxomas and cellular angiofibromas are rare mesenchymal tumours with many overlapping radiological, histopathological and immunohistochemical features. Amongst these tumours angiomyofibroblastoma is relatively benign mesenchymal tumour with very low chances of recurrence. It is clinically confused with bartholin gland cyst due to its well demarcated and smooth appearance. Due to overlapping histopathological features its very difficult even for experienced pathologists to differentiate between these mesenchymal tumours. Earlier desmin reactivity was thought to be specific for angiomyofibroblastoma but recently many aggressive angiomyxomas have also been found to be positive for desmin. Ultrasound, computed tomography and magnetic resonance imaging may be useful in diagnosis and ruling out more sinister malignancies. A well demarcated lesion with characteristic histopathological appearance of alternating hypo and hypercellular edematous regions with abundant blood vessels and stromal cells with dispersed chromatin is usually seen in angiomyofibroblastoma. Immunohistochemistry may further help in diagnosis. We here report a case of vaginal angiomyofibroblastoma. The diagnosis was made on the basis of imaging and was confirmed by histopathology and immunohistochemistry.