J Menopausal Med.  2016 Dec;22(3):180-183. 10.6118/jmm.2016.22.3.180.

Superficial Angiomyxoma of the Vulva in a Postmenopausal Woman: A Case Report and Review of Literature

• Lee SH
• Cho YJ
• Han M
• Bae JW
• Park JW
• Oh SR
• Kim S

• KMID: 2378239
• DOI: http://doi.org/10.6118/jmm.2016.22.3.180

Abstract

Superficial angiomyxomas (SAMs) are rare benign cutaneous tumors that involve the subcutaneous layer. They are commonly located in the trunk, lower limbs and head or neck of women of reproductive age. SAMs in the vulva of postmenopausal women are especially rare case. Herein, we report a vulvar SAM in a postmenopausal 60-year-old woman. The patient presented with a palpable cutaneous mass in the right labium majora that had appeared 3 months earlier. The mass was slow growing and approximately 5 cm in size and resembled a soft tissue malignancy. It appeared as a well-defined multilocular cystic mass in magnetic resonance images. The preoperative diagnosis was a benign cystic lesion such as an epidermoid cyst. Grossly, the completely excised mass was 6 × 5 cm in size and well circumscribed with a multilocular outer surface, a yellowish-gray gelatinous cut surface, and a smooth rubbery inner surface. Histologic review revealed that the mass contained small to moderate amount of cellular angiomyxoid nodules and bland-looking spindle-shaped to ovoid cells without atypia. Neutrophil infiltration, which is a diagnostic feature of SAMs, was observed. Immunohistochemistry showed expression of CD34, but not of estrogen receptors, progesterone receptors, or desmin in the SAM. The patient has been followed up for 12 months without recurrence.

Keyword

Myxoma; Postmenopause; Soft tissue neoplasms; Vulvar neoplasms

MeSH Terms

Desmin
Diagnosis
Epidermal Cyst
Female
Gelatin
Head
Humans
Immunohistochemistry
Lower Extremity
Middle Aged
Myxoma*
Neck
Neutrophil Infiltration
Postmenopause
Receptors, Estrogen
Receptors, Progesterone
Recurrence
Soft Tissue Neoplasms
Vulva*
Vulvar Neoplasms
Desmin
Gelatin
Receptors, Estrogen
Receptors, Progesterone

Figure

• 

  Fig. 1 T2-weighted magnetic resonance image shows a relatively well-circumscribed mass with inner homogenous high signal intensity.

• 

  Fig. 2 Histologic and imprint cytologic findings. (A) The mass consists of hypocellular myxoid tissue admixed with some adipose and collagenous tissue (hematoxylin and eosin [H & E] ×40). (B) The mass is composed of bland-looking, spindle to ovoid cells without cellular atypia, consistent with histologic features of superficial angiomyxoma (H & E ×200). (C, D) The tumor cells are immunoreactive for CD34 (C, H & E ×40; D, H & E ×200).

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