Painful cellular angiofibroma of the vulva: case report

Introduction Cellular angiofibroma is a rare benign mesenchymal tumour that occurs in the subepithelial myxoid stromal zone of the vulvovaginal region. We report a case of painful angiofibroma in a 52-year-old morbidly obese female, in the left labia. Case report A 52-year-old morbidly obese (body mass index of 67) female was referred to our gynaecologic oncology clinic with a 3-year history of a large, painful, pendulous left vulvar mass. Magnetic resonance imaging of the lesion helped confirm that the mass did not represent a hernia and was fibrous in nature. Resection revealed a 12 × 12 × 9 cm, a 187-gram encapsulated mass. Histologically, it was a well circumscribed tumour composed of hyalinised blood vessels and collagen bundles, exhibiting characteristic immunohistochemical features of a cellular angiofibroma. Conclusion Angiofibroma of the vulva is a rare benign encapsulated mass, yet hypervascular. Its diagnosis in a morbidly obese patient is challenging and necessitates magnetic resonance imaging or CT scan. Its surgical removal needs precision and meticulousness especially in a patient with multiple comorbidities.