A 25-year-old woman with a 2-week history of a huge, rapidly growing, foul-smelling genital growth presented with high-grade fever, dehydration, and features of sepsis. The 70-pound tumour, with skin ulcerations and purulent discharge, was carried over the abdomen. The pedunculated, twisted tumour from the left labia majora depicted in the Figure
was multilobulated, the and initial differential diagnosis included myxoid sarcoma or a large condyloma with superadded bacterial infection. No other similar growth in the body was found, and magnetic resonance imaging revealed that the soft tissue lesion was confined only to the vulva with no bony or pelvic extensions. The growth after untwisting was seen to exclusively arise from the left labia majora. Wide local excision was performed, and the microscopic features suggested giant superficial angiomyxoma.
The clinical presentation was highly suggestive of aggressive angiomyxoma, but this was not confirmed in view of thin interspersed large vessels, spindle-shaped fibroblasts with bland nuclei, and moderate eosinophilic cytoplasm. The tumour cells were positive for desmin and negative for ER, PR, and CD34 markers, strongly suggestive of giant superficial type. The tumour margins were free, and no local recurrence was seen with 24 months of follow-up.
Published online: June 28, 2021
© 2020 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.