Recurrent cellular angiofibroma of the vulva

Cellular angiofibroma is a benign mesenchymal lesion that was first described in 1997,1 and which chiefly involves the vulval region. The original report described four cases of this distinctive lesion, all occurring in middle aged women, and the authors considered this to represent a benign neoplasm with little or no potential for local recurrence if excised with a rim of uninvolved normal tissue. Since then, an identical lesion has been described in a woman involving the subcutaneous tissue of the chest wall.2 Similar lesions have also been reported in the inguinoscrotal region of men.1,3 Here, we describe a vulval cellular angiofibroma that, although initially excised with a rim of normal tissue, exhibited tumour recurrence in a relatively short time period. A 49 year old woman presented with a mass in the posterior aspect of the left labia majora. A well circumscribed lesion measuring 4 cm in diameter was excised with a rim of normal tissue. Six months later she developed a recurrent swelling at the site of the previous excision. This lay in the angle between the posterior wall of the vagina and the anterior aspect of the external anal sphincter. A magnetic resonance imaging scan confirmed the presence of a recurrent lesion and the mass was excised. The mass was well circumscribed and was dissected free without complication. Ten months after excision of the recurrent lesion the patient is well with no further evidence of local …