Abstract
Superficial angiomyofibroblastomas are mesenchymal tumours that occur in the genital tract and are well described pathologically. This case report reviews the imaging appearances and highlights the MRI findings, which have not been previously described. We describe the occurrence of this lesion in a vaginal cyst, which to the authors’ knowledge, has also not been previously described. The histological findings are also presented here.
Highlights
Mesenchymal tumours of the female genital tract are well described pathologically but the imaging findings are less well documented
We present a case of an unusual mesenchymal tumour of the female genital tract, highlight the key sonographic and MRI findings and summarise the current diagnostic and management approach
The tumours have a very characteristic immunohistochemical profile and are positive for oestrogen and progesterone, CD34, vimentin and desmin,[1,2] but do not express smooth muscle actin, which distinguishes them from leiomyomas.[5]
Summary
Mesenchymal tumours of the female genital tract are well described pathologically but the imaging findings are less well documented. Clinical history A 50-year-old female presented with a history of prolonged menstrual bleeding and right iliac fossa discomfort Her past medical history of note included endometriosis, a partially septate uterus and two previous lower segment cesarean sections. Imaging findings Initial pelvic ultrasound demonstrated normal uterus and ovaries, but detected a 13 mm vascular soft tissue nodule in a 28 × 20 × 25 mm cystic lesion in the left posterior vaginal fornix (Figure 1). The patient proceeded to have a non-contrast enhanced MR study This confirmed a well-defined, predominantly cystic, 24 × 31 × 24 mm structure in the left vaginal fornix of mildly hyperintense signal on T2 weighted (T2W). The patient returned with persistent vaginal bleeding and repeat imaging showed the cystic component had increased in size and measured 38 × 44 × 38 mm, but there was no change in the solid component. Follow up Sonographic surveillance over a period of 8 years has not demonstrated local recurrence
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