Angiomyofibroblastoma (AMF) is a rare mesenchymal tumor most commonly found in the female lower genital tract1. It consists of mainly stromal cells and prominent vasculature. Together with aggressive angiomyxoma AAM) and cellular angiofibroma (CAF), AMF belongs to the mesenchymal tumor group which are usually benign2. Sarcomatous transformation has been reported but it is very rare. AMF commonly affects premenopausal women and may resemble Bartholin’s cyst. It is important to have a histological diagnosis as its mimic AAM is more locally infiltrative and has high recurrence rate after excision.

We describe 5 cases of AMF (Table 1) who presented to KK Women’s and Children’s Hospital between 2012 and 2022.  They presented at different ages (41, 46, 61, 61, 71 years) with enlarging vulva lumps. Imaging studies of the vulva lesions mostly showed non-specific features which are not concerning for malignancy. All patient underwent excision of the lesions with histological confirmation of AMF (Figures 1-3) and recovered well postoperatively.

Our case series highlighted the possibility of women in the older age group developing AMF and the importance of a histological diagnosis for prognostication and follow up planning. AMF should be considered as a differential in any women who presents with a long-standing vulva lump so that appropriate treatment can be offered.