What are the other Names for this Condition? (Also known as/Synonyms)

• AMF of Vagina
• AMFB of Vagina
• Vaginal Angiomyofibroblastoma

What is Angiomyofibroblastoma of Vagina? (Definition/Background Information)

• Angiomyofibroblastoma (AMF or AMFB) of Vagina is a benign tumor of the soft tissues that occurs in the vagina of young and middle-aged women
• The cause of Angiomyofibroblastoma of Vagina is unknown and no definitive risk factors have been identified
• Most tumors do not present significant signs and symptoms. Some may grow to larger sizes and can cause emotional stress and pressure in the pelvic region
• Surgical excision of the tumor is the preferred method of treatment. With adequate treatment, the prognosis of Angiomyofibroblastoma of Vagina is generally excellent, since it is a benign tumor

Who gets Angiomyofibroblastoma of Vagina? (Age and Sex Distribution)

• Angiomyofibroblastoma of Vagina is a rare tumor that mostly affects females in the age group 25-50 years; even though a wider age range (17-88 years) may be observed
• There is no known ethnic group or racial preference
• Even though angiomyofibroblastoma is a rare tumor, about 10-15% of them are seen to arise in the vagina

What are the Risk Factors for Angiomyofibroblastoma of Vagina? (Predisposing Factors)

• Currently, no specific risk factors for Angiomyofibroblastoma of Vagina have been identified
• The tumors are mostly seen during the active reproductive years in women

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Angiomyofibroblastoma of Vagina? (Etiology)

• The exact cause and mechanism of Angiomyofibroblastoma of Vagina formation is unknown
• Some tumors have revealed certain genetic abnormalities that are being currently researched upon
• Some researchers believe that angiomyofibroblastomas are mesenchymal tumors. The mesenchyme is the middle layer of the 3 primary germ layers of an embryo, namely the ectoderm, mesoderm, and endoderm. The mesoderm gives rise to mesenchymal tissue, which is the source for bone, muscle, connective tissue, and dermis of skin

Vaginal Angiomyofibroblastoma is not a sexually-transmitted disease/condition.

What are the Signs and Symptoms of Angiomyofibroblastoma of Vagina?

Angiomyofibroblastoma of Vagina signs and symptoms may include:

• The benign tumors grow at a very slow rate and may present no pain or tenderness
• The soft tissue tumors are well-circumscribed with clear borders
• Angiomyofibroblastomas can occur as a polyp in the vulva or vagina
• The tumors are firm and solid with a rubbery feel
• In rare cases, the tumor may be observed to form a bag-like structure (pedunculated tumor)
• Some women may experience a sense of pressure in the region, if the tumor grows to large sizes
• Majority of the tumors are less than 5 cm in size, while some grow undetected to up to 14 cm, due to a lack of significant signs and symptoms during the initial development stages
• Pain during sexual intercourse
• Large tumors may result in the following:
  • Pain in the pelvic region
  • Frequent urination due to compression/pressure of the tumor
  • Lower back pain

In general, almost all the angiomyofibroblastoma tumors are observed in the pelvic region, between the anus and the genitalia. Rarely, in females, they are noted to form in the urethra or fallopian tube.

How is Angiomyofibroblastoma of Vagina Diagnosed?

A diagnosis of Vaginal Angiomyofibroblastoma is made using the following tools:

• Evaluation of the individual’s medical history and a thorough physical (pelvic) examination
• Ultrasound scan of the abdomen
• CT or CAT scan with contrast of the abdomen and pelvis may show a well-defined mass. This radiological procedure creates detailed 3-dimensional images of structures inside the body
• MRI scans of the abdomen and pelvis: Magnetic resonance imaging (MRI) uses a magnetic field to create high-quality pictures of certain parts of the body, such as tissues, muscles, nerves, and bones. These high-quality pictures may reveal the presence of the tumor
• Colposcopy:
  • The cervix (including the vagina and vulva) is examined with an instrument, called a colposcope. This helps the physician get a magnified view of the cervix
  • In order for this procedure to be performed, the individual has to lie on a table, as for a pelvic exam. An instrument, called the speculum, is placed in the vagina to keep the opening apart, in order to help the physician visualize the cervix. The colposcope is then used to get a magnified view of the inside

Although the above modalities can be used to make an initial diagnosis, a tissue biopsy of the tumor is necessary to make a definitive diagnosis to begin treatment. The tissue for diagnosis can be procured in multiple different ways which include:

• Fine needle aspiration (FNA) biopsy of the tumor: A FNA biopsy may not be helpful, because one may not be able to visualize the different morphological areas of the tumor. Hence, a FNA biopsy as a diagnostic tool has certain limitations, and an open surgical biopsy is preferred
• Core biopsy of the tumor
• Open biopsy of the tumor

Tissue biopsy:

• A tissue biopsy of the tumor is performed and sent to a laboratory for a pathological examination. A pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. Examination of the biopsy under a microscope by a pathologist is considered to be gold standard in arriving at a conclusive diagnosis
• Biopsy specimens are studied initially using Hematoxylin and Eosin staining. The pathologist then decides on additional studies depending on the clinical situation
• Sometimes, the pathologist may perform special studies, which may include immunohistochemical stains, molecular testing, and very rarely, electron microscopic studies to assist in the diagnosis

Note: The tumor can present diagnostic challenges as they are often confused during the initial stages for a Bartholin’s cyst, and with an aggressive angiomyxoma (when observed under a microscope).

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Angiomyofibroblastoma of Vagina?

Complications due to Angiomyofibroblastoma of Vagina could include:

• Emotional stress due to a concern for cancer
• The presence of the tumor can lead to painful sexual intercourse
• If the tumor is large and has infiltrated deep into adjoining regions, it may lead to significant risks during surgical operations, which could include damage of vital nerves, blood vessels, and other adjoining organs
• Post-surgical infection at the wound site is a potential complication
• Extremely rarely, the tumor may recur following their surgical excision and removal

How is Angiomyofibroblastoma of Vagina Treated?

Treatment measures for Angiomyofibroblastoma of Vagina may include the following:

• The healthcare provider may recommend a ‘wait and watch’ approach for small-sized tumors that do not cause any significant signs and symptoms, after a diagnosis of angiomyofibroblastoma has been established
• Pain medications, in case of tumors causing pain
• Surgical intervention with complete excision can result in a complete cure. It can also help reduce the chances of tumor recurrence. The various techniques used may include:
  • Myolysis of the tumor: In this procedure, a needle is inserted into the tumor. After the insertion, the tumor is destroyed either by using an electric current, or by a freezing technique
  • Tumor embolization is a possible treatment option. Here the blood supply to the tumor is blocked resulting in tumor death
  • Radiofrequency ablation: In this technique, the tumors are destroyed using radio waves
• Radiation therapy and chemotherapy are not usually required
• Some women may require reassurance and support to help with stress and anxiety. The healthcare professional may dispel fears that the condition is not due to a sexually-transmitted infection
• Post-operative care is important: Minimum activity level is to be ensured until the surgical wound heals
• Follow-up care with regular screening and check-ups are important and encouraged

How can Angiomyofibroblastoma of Vagina be Prevented?

• Current medical research has not established a way of preventing Angiomyofibroblastoma of Vagina
• Medical screening at regular intervals with scans and physical examinations are advised

What is the Prognosis of Angiomyofibroblastoma of Vagina? (Outcomes/Resolutions)

• Angiomyofibroblastoma of Vagina is a benign tumor and the prognosis is excellent with suitable treatment
• There is no risk of recurrence following its complete surgical removal

Additional and Relevant Useful Information for Angiomyofibroblastoma of Vagina:

Please visit our Cancer & Benign Tumor Health Center for more physician-approved health information:

http://www.dovemed.com/diseases-conditions/cancer/