Cellular angiofibroma

Cellular Angiofibroma

Cellular angiofibroma is a rare, benign tumor that typically arises in the soft tissues of the genital and pelvic regions. First described in 1997, this condition presents more commonly in adult females but can also occur in males. Characterized by its cellular composition and vascular structure, cellular angiofibroma is important to distinguish from other soft tissue tumors due to its benign nature and excellent prognosis following surgical removal.

Clinical Presentation

Patients with cellular angiofibroma often present with a slow-growing, painless mass in the vulvar or inguinal area. The size of the tumor can vary significantly, ranging from a few millimeters to several centimeters in diameter. In males, the scrotum is the most common site of occurrence. Despite its benign behavior, larger tumors may cause discomfort or pressure symptoms depending on their size and location.

Pathology

Histologically, cellular angiofibroma is characterized by a well-circumscribed lesion composed of spindle cells, significant vascular proliferation, and a variable amount of collagen. The tumor cells are typically arranged in short fascicles or a storiform pattern, and mitotic figures are rare, reflecting the benign nature of the tumor. Immunohistochemically, the tumor cells express markers such as CD34, a feature that helps in distinguishing cellular angiofibroma from other soft tissue tumors.

Diagnosis

The diagnosis of cellular angiofibroma is primarily based on histological examination of the biopsy or surgical specimen. Imaging studies, such as ultrasound or magnetic resonance imaging (MRI), can be useful in assessing the extent of the tumor and planning surgical excision but are not diagnostic. Differential diagnosis includes other benign and malignant soft tissue tumors, making histological analysis crucial for accurate diagnosis.

Treatment and Prognosis

The treatment of choice for cellular angiofibroma is complete surgical excision. Given its benign nature, the prognosis after complete removal is excellent, with a very low risk of recurrence. There is no role for adjuvant therapy in the treatment of cellular angiofibroma.

Epidemiology

Cellular angiofibroma is a rare tumor, with a slightly higher prevalence in females. It typically occurs in middle-aged adults but can be found in individuals of any age.

Conclusion

Cellular angiofibroma is a benign soft tissue tumor with distinctive histological features. Its recognition is essential for the appropriate management and to avoid overtreatment of this benign condition. Surgical excision is curative, and the prognosis is excellent.