Angiomyofibroblastoma of the vulva: report of a case with immunohistochemical and molecular analysis.

A 43-year-old woman presented with a mass in the subcutaneous tissue of the right labium majus. A lipoma or Bartholin gland cyst was suspected and excision of the lesion was performed. The lesion was well circumscribed, and histological examination revealed a typical angiomyofibroblastoma. The lesion was composed of alternating hypocellular edematous and hypercellular areas with abundant vessels, and plump tumor cells were loosely dispersed or aggregated mainly around the vessels. Tumor cells were immunoreactive for vimentin and desmin but negative for muscle actins. Ultrastructurally, the tumor cells contained a moderate amount of rough endoplasmic reticulum and abundant intermediate filaments, and had primitive junctions. Pinocytotic vesicles or basal lamina were not evident. Immunohistochemical studies also revealed that the tumor cells expressed basic fibroblast-growth factor, vascular-endothelial-growth factor, and stem-cell factor, factors that may contribute to the rich vascularity and mast cells within the tumor. Reverse transcription-polymerase chain reaction detected high mobility group I-C (HMGI-C) transcripts in the tumor tissue. Because the expression of HMGI-C is regulated by developmental and differentiation processes and is not found in adult normal tissues, HMGI-C may be involved in the tumorigenesis of angiomyofibroblastoma.