Superficial myofibroblastoma of the vagina with a stalk: case report of a rare vaginal tumor with notable radiological findings

A giant superficial myofibroblastoma involving the vagina and pelvis: A case report and review of the literature

Superficial myofibroblastoma is a rare benign mesenchymal tumor that presents a challenge in accurate preoperative diagnosis because of its overlapping radiological and histological features. A 27-year-old woman presented with a history of increasing abdominal girth over the prior year and pelvic mass for 1 month. Imaging confirmed the presence of a giant well-circumscribed cystic-solid tumor involving both the extraperitoneal pelvis and vagina. After exploration and excision, superficial vaginal myofibroblastoma was diagnosed pathologically. The patient underwent surgical excision and had no postoperative complications at the 1-month follow-up. Imaging features and clinical reasoning can aid in differentiating superficial myofibroblastoma from more aggressive entities or malignant tumors and guide suitable and appropriate surgical approaches.

Superficial vaginal myofibroblastoma with mushroom-like appearance: A case report with colposcopic findings and literature review

Superficial myofibroblastoma (SMF) of the lower female genital tract is a relatively rare benign mesenchymal tumor. The diagnosis is usually challenging as it shares several similar clinicopathological features with other tumors. Herein, we present a case of a 71-year-old Chinese female patient with postmenopausal vaginal bleeding. Colposcopy imaging revealed a well-circumscribed mass in the vagina with a wide pedicle, resembling a mushroom. The patient underwent surgery, and the tumor was histologically diagnosed as SMF. To the best of our knowledge, this is the first report of colposcopic imaging of a superficial vaginal myofibroblastoma. In this case study, we review the clinicopathological features of SMF of the lower female genital tract reported in the literature to improve the understanding of the disease.

Superficial myofibroblastoma of the lower female genital tract: A clinicopathological analysis of 15 cases

OBJECTIVE

To describe the clinicopathological features and differential diagnoses of 15 cases of superficial myofibroblastoma, a rare mesenchymal tumor involving the lower female genital tract.

METHODS

The clinicopathological data and immunohistochemical findings were retrospectively analyzed in 15 cases of superficial myofibroblastoma. Meanwhile, a systematic literature review was conducted.

RESULTS

The age of patients ranged from 34 to 73 years (median, 49 years). Most patients presented with nodular or polypoid masses ranging in size from 0.4 cm to 6.5 cm. Twelve tumors were located in the vagina, two in the vulva, and one in the cervix. Microscopically, the tumor was located in the subepithelial tissue, with a clear boundary and without capsule on the surface. The tumor cells were spindle, oval, stellate or wavy, and arranged in various architectural patterns of reticular, fascicular, wavy and disorderly patterns. There were no obvious cellular atypia and mitotic figures. Thin collagen fibers and thin-walled vessels could be observed in all cases. Most cases were diffusely and strongly reactive to Vimentin (12/12), Desmin (14/15), ER (15/15) and PR (13/14). Variable immunoreactivity for CD34 (8/15), Caldesmon (2/8), SMA (4/14) and CD99 (4/5) were observed. The tumors showed a low Ki67 proliferative index (≤5 %). Follow-up information was available in 10 patients and there was no evidence of recurrence or metastasis.

CONCLUSIONS

Superficial myofibroblastoma is a rare benign tumor that originates from the hormone-sensitive, subepithelial mesenchymal tissue of the lower female genital tract, and should be differentiated from other mesenchymal tumors.