Angiomyofibroblastoma-like tumor of the scrotum: A case report and literature review

Sonographic appearance of angiomyofibroblastoma-like tumor of the scrotum

A variety of extratesticular tumors and tumor-like conditions can occur in the scrotum. Angiomyofibroblastoma is a rare, slow-growing, well-circumscribed mesenchymal tumor, found predominantly in women, and is even a more unusual occurrence in the male genital tract. We describe a case of a 64-year-old male presenting with a scrotal painless mass. On sonography, a well-circumscribed extratesticular mass was present. As no specific imaging findings were present, it was a surprise to learn that the subsequently excised mass proved to be an angiomyofibroblastoma-like tumor. To the best of our knowledge, the sonographic appearance of this tumor in the scrotum has been reported previously in only one case.

Spermatic cord paratesticular tumor: a rare case report

Paratesticular tumors account for 5% of tumors originating in the scrotum. Angiomyofibroblastoma-like tumor is a rare benign mesenchymal soft tissue tumor found in the genital region in both sexes and is even rarer in the spermatic cord. The origin of this tumor remains the object of speculation, but it is believed to originate from perivascular mesenchymal cells. The purpose of the present case report is to expand knowledge on the histology of this rare paratesticular tumor.

Vaginal Angiomyofibroblastoma: A Case Report and Review of Diagnostic Imaging

Background

Angiomyofibroblastoma (AMFB) is a benign mesenchymal tumor most commonly found in the female genital tract of premenopausal women. Although rare, AMFB is an important consideration in the differential diagnosis of vulvar and vaginal masses, as it must be distinguished from aggressive angiomyxoma (AA), a locally recurrent, invasive, and damaging tumor with similar clinical and pathologic findings.

Case

We describe a patient with a 4 cm vaginal AMFB and the relevant preoperative radiographic imaging findings.

Conclusion

Preoperative diagnosis of AMFB remains difficult. Common findings on magnetic resonance imaging and transvaginal sonography are described. We conclude that both transvaginal ultrasound and MRI are potentially useful imaging modalities in the preoperative assessment of vulvar and vaginal AMFB, with more data needed to determine superiority of one modality over the other.

Imaging features of mammary-type myofibroblastoma of soft tissue: a case series with literature review

Mammary-type myofibroblastoma (MTM) is a rare, benign neoplasm that is histologically identical to myofibroblastoma of the breast, but occurring in an extramammary site. The masses have been reported in superficial and deep soft tissue sites and visceral locations with the inguinal area and lower extremities are the most common. Most previous reports of MTMs have concentrated on clinical and pathological findings, with very limited information regarding imaging characteristics. Here, we describe three cases of MTM diagnosed at our institution, with a focus on imaging findings. We compare our findings with previously reported cases. Although MTM is rare, radiologists should be aware of this benign diagnosis as imaging characteristics can mimic those of liposarcomas and atypical lipomatous tumor/well-differentiated liposarcoma. Unlike those tumor types, MTM virtually never recurs post-resection, even when there are positive margins. Biopsy is necessary for proper diagnosis and recommended as an initial step to avoid overly aggressive treatment.

Angiomyofibroblastoma of the vulva diagnosed preoperatively: A case report

A 50-year-old woman (gravida 2, para 2) first noticed a small nodule in the right labium majus 2 years prior to the initial visit to the Hachinohe Red Cross Hospital (Hachinohe, Japan), which had gradually increased in size. On physical examination, a well-circumscribed, elastic, firm, goose egg-sized, subcutaneous mass protruding from the right labium majus was identified. On magnetic resonance imaging (MRI), the lesion was hypointense on T1-weighted images and was well-circumscribed, strongly enhanced and homogeneous on gadolinium-enhanced images, measuring 7.5×4 cm. The same tumor had measured 2.6 cm on an MRI performed 6 years earlier. Based on the clinical course and imaging findings, angiomyofibroblastoma was diagnosed and surgical resection of the tumor was performed. The tumor was well-circumscribed and highly vascular. The intraoperative blood loss was 70 ml. Histopathologically, the tumor cells were concentrated around blood vessels, were spindle-shaped to oval with mild atypia, and were positive for vimentin, desmin, neural cell adhesion molecule (N-CAM), CD-34, estrogen receptor and progesterone receptor, and negative for S-100. Based on these findings, the diagnosis of angiomyofibroblastoma was confirmed. Angiomyofibroblastoma is a benign mesenchymal tumor that occurs in the female external genitalia. Differentiation of this tumor from aggressive angiomyxoma, a fast-growing infiltrative malignancy that occurs in the same region, may be challenging. The diagnosis of angiomyofibroblastoma is usually based on the histopathological findings of the resected specimen. The present case is of value, as the angiomyofibroblastoma was successfully diagnosed preoperatively based on the clinical course and imaging findings.

Angiomyofibroblastoma of the mediastinum: A case report and literature review

INTRODUCTION

Angiomyofibroblastoma (AMFB) is an extremely rare disease. It commonly occurs in middle-aged females and mainly involves the vulvovaginal region. Pathological examination plays an important role in differentiating from other tumors. But far less published literature focus on the imaging characteristics of AMFB.

CLINICAL FINDINGS/DIAGNOSES

We reported a case of AMFB in a 73-year-old male, involving the mediastinum with computed tomography (CT) imaging and pathologic findings. Preoperative unenhanced CT scan of chest revealed a 6.9 × 7.4 × 9.3 cm mass with equal density, located in the posterior mediastinum. On contrast-enhanced CT images, the tumor presented moderate, heterogeneous enhancement. Due to the unclear interface between the tumor and adjacent tissues, this patient underwent operative partial resection of the tumor. The pathologic diagnosis was AMFB.

CONCLUSIONS

This tumor represents a further example of unusual location different from conventional AMFB. This case adds to the experience with AMFB by summarizing its characteristics, and also reviewing the literature.

Mesenchymal Extratesticular Tumors and Tumorlike Conditions: From the Radiologic Pathology Archives

Both benign and malignant tumors and tumorlike conditions can arise from the nonepididymal extratesticular tissues. Benign tumors are far more common than malignant tumors, with lipoma being the most common lesion found at this site. Several imaging features can help narrow the differential diagnosis of these lesions, including the presence of fat and imaging features suggestive of fibrous tissue. Lesions that contain fat represent lipoma, liposarcoma, or angiomyofibroblastoma (AMF)-like tumor. If enhancing soft tissue is present in conjunction with fat, the differential diagnosis narrows further to just liposarcoma and AMF-like tumor. Lesions that display magnetic resonance imaging characteristics compatible with fibrous tissue are likely to be fibrous pseudotumor. However, many of the lesions in this location have overlapping imaging findings, and surgical excision is most often necessary for accurate diagnosis. The ability to narrow the differential diagnosis with imaging, however, is helpful for the clinician for both treatment planning and patient counseling.

Giant pelvic angiomyofibroblastoma: case report and literature review

Angiomyofibroblastoma (AMF) is a rare, benign, soft-tissue tumor, which predominantly occurs in the vulvovaginal region of middle-aged women. It is clinically important to distinguish an AMF from other stromal cell lesions. Here, we report the case of a 32-year-old woman with a rare, giant pelvic AMF, which showed a benign clinical course. The tumor was located in the cul-de-sac of Douglas. It was well demarcated, hypocellular, edematous and composed of spindle-shaped and oval stromal cells aggregating around thin-walled blood vessels. The tumor cells had abundant eosinophilic cytoplasm, and expressed estrogen receptors, progesterone receptors and desmin. Mitotic figures were absent. It is important to distinguish AMFs from aggressive angiomyxomas because both occur at similar sites but show different clinical behaviors. Most AMFs and aggressive angiomyxomas have the same immunohistochemical phenotype. The well-circumscribed borders of AMF are the most important characteristic that distinguish it from aggressive angiomyxomas. AMFs rarely recur after complete surgical excision.