A 35 year old woman, Hosp. No. - A 8332 came to our OPD on 05.08.05 with chief complaints of growth in the vulva - 2 month, bleeding from the growth - 1 month, irregular period - 6 month. She is P4+1. She chews betel nut and leaf. There is no family history of malignancy. No history of HTN, DM, TB. Tubectomy was done a year ago.
On examination, GC is fair, pallor +, no palpable LN. P/A- no organomegaly, others NAD, groin- NAD. Local examination of the vulva revealed a 8 x 5 cms pedunculated growth [Figure 1] having its thick pedicle of about 1.5 cm thickness hanging from the clitoreal region slightly on the left side [Figure 2]. P/S/V- cervix- NAD, vaginal walls- NAD, Uterus - N/S, mobile, adnexae free. P/R- NAD.
On investigation, Hb %- 9.8 gm%, ABO gr.- O +ve, RBS- 101 mg/dl, RFT-WNL, LFT-WNL. PAP Smear-NAD, CXR-NAD, USG (W/A) - NAD. Pre operative biopsy revealed Aggressive Angiomyxoma.
She was planned for wide excision of the vulval growth; accordingly it was done under SA on 18.08.05 [Figure 3]. On sectioning, the mass had focally infiltrating margins and a rubbery glistening grey/white surface [Figure 4]. Post operative period was uneventful, and patient was discharged on 27.08.05.
Post op HPE revealed Aggressive Angiomyxoma [Figures 5 and 6], cut margins negative. IHC studies revealed Desmin and Vimentin +ve, ER, PR +ve and S100 protein negative. She is under regular follow-up, and doing well for the last 5 years.