Case History

61-year-old female with vaginal wall mass.

Answer choices:

  1. Fibroepithelial polyp
  2. Superficial myofibroblastoma
  3. Keloid
  4. Cellular angiofibroma

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B. Superficial myofibroblastoma

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Brief Explanation of the answer:

The findings in this case show a submucosal, nodular mass of bland spindle to oval cells and scattered mast cells in a background of thick collagen material. No atypia or mitotic figures are identified. The overlying mucosa is unremarkable. The immunoprofile of this lesion is CD34 and desmin positive, S-100 negative.

Superficial myofibroblastomas occur in adults and typically present as a superficial mass in the vagina, vulva, or cervix and average 2 to 3 cm in size. Microscopically, a moderately cellular proliferation of bland spindle cells are noted within collagenous stroma. Multiple patterns of growth can be present, including lacelike, fascicular, storiform, myxoid, and hyalinized, but a patternless pattern is most common. Thin-walled blood vessels can be seen concentrated in the center of the lesion. The immunoprofile shows positivity for ER, PR, desmin, vimentin staining and variable positivity for CD34. Keratins and S-100 are negative. Treatment is complete local excision as they have been reported to recur if incompletely excised.


Soong, Thing R, Nucci, Marisa R, and Crum, Christopher P. “Neuroendocrine Carcinoma, Mixed Epithelial/Mesenchymal, and Mesenchymal Tumors, and Miscellaneous Lesions of the Cervix”. Diagnostic Gynecologic and Obstetric Pathology. 3rd ed. 2018.

Clement, Philip B and Young, Robert H. “Non-neoplastic Lesions and Benign Tumors of the Vulva”. Atlas of Gynecologic Surgical Pathology. 3rd ed. 2014.

Case contributed by: Joseph Drwiega, M.D., Fellow, Anatomic Pathology