Superficial myofibroblastoma of the lower female genital tract: case report and literature review

Abstract

Introduction: Superficial myofibroblastoma of the lower female genital tract is a benign mesenchymal tumor preferentially located in the vagina, but may also arise in the cervix and vulva. This article provides a comprehensive review of the literature as well as describes a case report to help correlate presentation with management. Methods: We conducted an extensive literature review without a defined time range and across three databases (Pubmed/Ovid, Embase, and Web of Science). Inclusion criteria specified all peer-reviewed publications of myofibroblastoma in the lower female genital tract in the English language. Results: Six hundred and seventy-three articles were identified, with 15 articles being included in the review based on eligibility criteria. There were 12 case reports, 3 case series, with a total of 56 cases from 53 patients. Age ranges were 23-80years (mean=55). Most gross examinations were described as polypoid or nodular in appearance, measuring 2 mm to 120mm (mean=39). All cases were clinically managed with either local excision or incidentally identified after a hysterectomy. There are no published recommendations for an optimal follow-up interval. Conclusion: The diagnosis of mesenchymal tumors in the female genital tract is challenging. Expression of Vimentin, Progesterone, Estrogen, Desmin, and CD34 is noted in the majority of SMGFT tumors while testing for CD99 and bcl-22 may assist in identification of challenging cases. Understanding the variety in presentation and immunohistochemical markers of superficial myofibroblastoma is significant as it may change surgical approach and follow-up to tumors of the lower female genital tract.