Superficial angiomyxoma of the vulva: A case report and literature review

Abstract

Background: Angiomyxomas are rare mesenchymal tumors. Aggressive angiomyxomas are
distinguished from superficial angiomyxomas by their propensity for local recurrence and metastatic
potential. Superficial angiomyxomas occur almost exclusively in women of reproductive age. Wide
surgical resection is the treatment of choice.
Case presentation: A 25-year-old para 1+1 presented with a mass on the vulva that had been increasing
in size over one month. Examination revealed a mushroom-like, verrucous mass on the left labia majora
with a raw surface measuring approximately 4 cm in diameter with a 2-cm stalk. It was easily bleeding on
touch and slightly tender. Biopsies were taken, and histology revealed features of superficial
angiomyxoma. The patient consented to wide excision of the vulval mass. The mass was excised
together with approximately 1.5 cm skin margin around it and a 2 cm depth of the underlying fatty base. A
final histological diagnosis of superficial angiomyxoma was made. The patient was followed up for three
months with no recurrence.
Conclusion: Superficial angiomyxomas are rare benign tumors of the subcutaneous tissue that occur
almost exclusively in women of reproductive age. They present as slow-growing masses on the ear,
trunk, and perineum. Wide surgical resection is the treatment of choice with adjuvant therapies, such as
selective estrogen receptor modulators and gonadotropin hormone-releasing hormone agonists, also
proving beneficial. Due to high rates of recurrence, long-term follow-up should be done for up to 15 years
following primary resection.