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

• CA of Vulva
• Vulvar CA
• Vulvar Cellular Angiofibroma

What is Cellular Angiofibroma of Vulva? (Definition/Background Information)

• Cellular Angiofibroma (CA) of Vulva is a rare, benign soft tissue tumor that is seen to originate below the skin of the vulva (area around the external vaginal opening), mostly in middle-aged adult women
• Some study reports indicate that certain hormonal factors may play a role in the formation of Cellular Angiofibroma of Vulva. The cause of the tumor may be due to certain chromosomal aberrations
• Vulvar Cellular Angiofibromas are generally painless; they may also remain undetected due to a lack of significant signs and symptoms. However, some are known to grow to large sizes and cause pain and compression of the adjoining genital organs
• The treatment of choice is a surgical removal of the entire tumor. The prognosis of Cellular Angiofibroma of Vulva is excellent with appropriate treatment

Who gets Cellular Angiofibroma of Vulva? (Age and Sex Distribution)

• Cellular Angiofibroma of Vulva is generally present in middle-aged adults; women in the age category of 40-50 years are affected the most (typical age range is 27-63 years)
• In general, cellular angiofibromas may be found in a wider age range of individuals (between 20-75 years), but the most frequent site of CA in women is the vulva
• There is no geographical, racial, or ethnic preference noticed

What are the Risk Factors for Cellular Angiofibroma of Vulva? (Predisposing Factors)

• No specific risk factors are evident for Cellular Angiofibroma of Vulva
• It is believed that certain hormones (such as estrogen and progesterone) may play a role in tumor development

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 Cellular Angiofibroma of Vulva? (Etiology)

The exact cause of Cellular Angiofibroma of Vulva development is unknown.

• Some research studies indicate that the tumor formation may occur due hormonal factors. The hormones that are involved include estrogen and progesterone
• Certain chromosomal abnormalities involving loss of genetic material has been implicated as the cause of tumor formation
• Cellular angiofibroma is also shown to be closely related to two benign tumors, namely mammary-type myofibroblastoma and spindle cell lipoma, on tumor cell genetic study

What are the Signs and Symptoms of Cellular Angiofibroma of Vulva?

The signs and symptoms of Cellular Angiofibroma of Vulva include:

• Cellular angiofibromas are slow-growing soft tissue masses; they can have a rubber-like consistency to touch
• The tumors are spherical or oval in shape (polyp-shaped); well-circumscribed, but with poorly-defined boundaries
• Cellular angiofibroma tumors can range in size from 6 mm to as large as 25 cm; the average size is about 3 cm. However, vulvar tumors have a range between 1-9 cm
• Most of the tumors appear as painless masses, due to which these are usually detected incidentally. Large-sized tumors may cause pain and compress surrounding structures and organs

How is Cellular Angiofibroma of Vulva Diagnosed?

Cellular Angiofibroma of Vulva diagnosis may involve 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 vulva and vagina) 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 tumors may be initially misdiagnosed as Bartholin’s cyst prior to a tissue biopsy.

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 Cellular Angiofibroma of Vulva?

The possible complications of Cellular Angiofibroma of Vulva include:

• Emotional stress and concern, especially with tumors in the genital region
• Tumor recurrence following surgery is known to take place in rare cases
• Damage of vital nerves, blood vessels, and surrounding structures, during surgery to remove the tumors
• Post-surgical infection at the wound site is a potential complication

How is Cellular Angiofibroma of Vulva Treated?

Following are the treatment methods adopted for Cellular Angiofibroma of Vulva:

• The healthcare provider may recommend a ‘wait and watch’ approach for small-sized tumors presenting mild signs and symptoms, after a diagnosis of cellular angiofibroma is made
• 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
• Radiation therapy and chemotherapy are not usually required
• 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, since the tumor can recur in some cases

How can Cellular Angiofibroma of Vulva be Prevented?

• Current medical research has not established a method of preventing Cellular Angiofibroma of Vulva
• Medical screening at regular intervals with scans and physical examinations are advised

What is the Prognosis of Cellular Angiofibroma of Vulva? (Outcomes/Resolutions)

• The prognosis of Cellular Angiofibroma of Vulva is generally excellent on surgical excision and removal of the tumor. It is a benign tumor with very little risk of recurrence
• Malignant transformations of cellular angiofibromas have not been observed. However, periodic follow-up check-ups with screening are advised

Additional and Relevant Useful Information for Cellular Angiofibroma of Vulva:

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

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