ANGIOMIXOMA SUPERFICIAL DE VULVA -RELATO DE CASO

Case Presentation: Patient A.C.A, 24 years old female, nulligesta, presented to oncogynecology outpatient clinic with the chief complaints of two painless soft tissue consistency masses on the labia minora for two years that became large polypoid lesions 5×5 cm without any inflammatory signs, along with hyperkeratotic lesions on the clitorial region that gave the appearance of cracked land and commonly resulted in folliculitis. Moreover, she had many hyperpigmentary spots on crural region and armpit. Then, the patient got gynecological, dermatological and genetic medicine assistance for diagnostic clarification. The computed tomography and magnetic ressonance of abdomen and pelvis didnt show any infiltrative abnormality or lymph node enlargement. In November 27th, 2018, the two polypoid lesions and the excess labia minora were surgically removed, and a incisional biopsy of two lesions on the clitorial area was realized. The histopathological diagnosis was a superficial angiomyxoma of vulva. The definitive surgery treatment was performed in July 9th, 2019 and it consisted of a simple vulvectomy, genital area reconstruction using remaing local tissues and clitoris preservation. Discussion: The superficial angiomyxoma is a rare benign neoplasia which consists in a aggregate of angiomyxoid nodules combined with diffuse small and medium caliber blood vessels. It occurs more in men and usually affects extragenital regions. The treatment consists in the surgical excision with a clear margin, as the case reported above. The most important differential diagnosis is the agressive angiomyxoma, which is more frequent, locally invasive and has high metastatic potential. In some cases, the angiomyxoid nodules are related with a autosomal dominant syndrome called Carneys complex , which is associated with endocrinopathies, endocrine and neuroendocrine tumors. Final comments: The superficial angiomyxoma is a rare benign tumor and the treatment consists in the complete surgical excision. Although there are few cases reported about it, the exposed case shows its a important differential diagnosis of nodules on genital area associated with recurrent folliculitis. Besides that, this case shows its possible to provide a complete surgical resolution and still to maintain the local aesthetics.

Publication History

Article published online:
23 October 2019