EP22.40: The role of ultrasound in diagnosis of vulvar angiomyofibroblastoma: a rare case of genital tumour – case report

Vulvar angiomyofibroblastoma (AMF) represents a rare tumour of uncertain histological origin. The literature reports about 70 cases of vulvar AMF. The treatment of choice is simple total excision, which is usually curative. We present the case of a 47 year old patient who presented to a routine gynecological evaluation. The clinical exam revealed on the right major labia of the vulva a 5/6 tumour, without tegumentary changes, mobile on the surface and flaccid consistence. The ultrasound evaluation identified an echoic tumour of the right major labia of the vulva. There was no suspicion of malignancy on ultrasound. We performed the excision of the tumour that was flesh, whitish solid with myxoid appearance. The pathology exam result was: vulvar angiomyofibroblastoma. The immunoprofile showed strong expression of vimentin, desmin and smooth muscle actin (SMA) immunoreactivity. Angiomyofibroblastoma is a rare benign tumour that may occur in the vulva. The differential include aggressive angiomyxoma, Bartholin cyst or lipoma. The peculiarity of our case is that the patient was diagnosed at a routine gynecological exam because she had no important symptoms and the ultrasound was the key for the diagnosis.