Angiomyofibroblastoma of the cervix in tamoxifen treated breast cancer patient

Abstract

The patient was a 61-year-old woman presenting with pelvic and vaginal discomfort who had a past history of breast cancer, and her treatment included tamoxifen therapy. She underwent total abdominal hysterectomy and left salpingo-oophorectomy, for left adnexal mass which was noticed on ultrasound. Macroscopically, a well circumscribed and homogenously white, nodule was identified within the cervix. Histologically, the nodule comprised of spindle to oval shaped tumour cells present around numerous thin walled blood vessels within a slightly myxomatous stroma. With the appropriate immunohistochemical stains a diagnosis of angio-myofibroblastoma was made. Angiomyofibroblastoma is a benign soft tissue neoplasm of mesenchymal origin, usually occurring in the female genital tract. Cervical presentation is extremely rare. The histogenesis of angiomyofibroblastoma is unknown and it has been postulated that the neoplastic cells most likely arise from mesenchymal cells in the subepithelial myxoid stromal zone. Some authors have suggested that tamoxifen may be causally related to angiomyofibroblastoma. However, further extensive studies are needed to establish the causal association between tamoxifen and angiomyofibroblastoma. The patient was a 61-year-old woman presenting with pelvic and vaginal discomfort who had a past history of breast cancer, and her treatment included tamoxifen therapy. She underwent total abdominal hysterectomy and left salpingo-oophorectomy, for left adnexal mass which was noticed on ultrasound. Macroscopically, a well circumscribed and homogenously white, nodule was identified within the cervix. Histologically, the nodule comprised of spindle to oval shaped tumour cells present around numerous thin walled blood vessels within a slightly myxomatous stroma. With the appropriate immunohistochemical stains a diagnosis of angio-myofibroblastoma was made. Angiomyofibroblastoma is a benign soft tissue neoplasm of mesenchymal origin, usually occurring in the female genital tract. Cervical presentation is extremely rare. The histogenesis of angiomyofibroblastoma is unknown and it has been postulated that the neoplastic cells most likely arise from mesenchymal cells in the subepithelial myxoid stromal zone. Some authors have suggested that tamoxifen may be causally related to angiomyofibroblastoma. However, further extensive studies are needed to establish the causal association between tamoxifen and angiomyofibroblastoma.