Angiomyofibroblastoma: A rare benign gynecologic tumor mistaken for a bartholin cyst

Background: Angiomyofibroblastoma is a rare, benign superficial vulvar lesion of the middle-aged female. Most cases in the literature are initially misdiagnosed as Bartholin gland cysts with final diagnosis ascertained via pathology at the time of surgical excision. Case: A 45-year-old female presented with a large, painless vulvar mass. This mass had formed five years prior to presentation to our clinic, and the patient underwent a procedure to attempt to drain the mass 2-3 years following its initial formation. At her initial visit, a 15 X 10 cm mass was found on the posterior aspect of the right labia minora at the level of the vaginal vestibule. This mass extended inferiorly to the perineum. Needle aspiration was attempted in office but was unsuccessful. The mass was removed under general anesthesia in the operating room en bloc from the vulva without complication and the patient was discharged on postoperative day 0. The pathology of this mass was reported as angiomyofibroblastoma. Conclusion: Differentiating angiomyofibroblastoma from other potential soft tissue masses of the vulva, especially from the commonly mistaken Bartholin gland cyst or rare aggressive angiomyxoma, is essential for preventing unnecessary procedural workup or treatment miss of a malignant mass. Noting the key distinguishing pathological and clinical features of the tumor and considering risk factors for malignancy will aid in correct diagnosis without exposing the patient to extraneous procedures and potential harm.