Management of a large angiomyofibroblastoma of the vulva: a case report describing radical excision and reconstruction.

Angiomyofibroblastoma is a rare, benign mesenchymal tumor of the vulvovaginal region, often misdiagnosed due to its nonspecific clinical presentation. Accurate diagnosis and appropriate surgical management are essential to achieve optimal oncological and aesthetic outcomes. This reports presents the case of a 28-year-old woman with a two-year history of a slowly enlarging, painless mass of the left labium majus. Clinical and ultrasonographic evaluation suggested a benign lesion. The patient underwent surgical excision via an interlabial sulcus approach, selected to ensure adequate exposure and optimal cosmetic outcome. Histopathological examination revealed a well-circumscribed mesenchymal tumor composed of spindle and oval stromal cells arranged around numerous thin-walled vessels, without atypia or mitotic activity. Immunohistochemistry showed positivity for desmin, estrogen receptors, and progesterone receptors, with negative staining for CD34 and S100 protein, confirming the diagnosis of angiomyofibroblastoma. The postoperative course was complicated by hematoma and edema, which resolved with conservative management. At one month, a favorable cosmetic outcome had been achieved, and no evidence of recurrence was observed at five-month follow-up. Angiomyofibroblastoma should be considered in the differential diagnosis of vulvar masses. Complete local excision is curative in most cases. In large tumors, careful surgical planning with reconstructive techniques is essential to achieve both oncological safety and satisfactory cosmetic results. Long-term follow-up is recommended despite the benign nature of the disease.