Cervical superficial myofibroblastoma: Case report and review of the literature

Abstract

Superficial myofibroblastoma of the lower female genital tract is a rare benign, recently recognized neoplasm that mostly affects the vulvovaginal area. Our report discusses a case of cervical superficial myofibroblastoma of the lower female genital tract in a 45-year-old patient who is presented with menometrorrhagia. On examination, she had multiple uterine fibroids and a circumscribed submucosal mass lesion involving the anterior lip of cervix. At hysterectomy, histopathological examination of the cervical mass revealed a relatively hypocellular tumor consisted of bland spindled and stellate cells. An immunohistochemistry evaluation revealed reactivity for CD34, desmin, and smooth muscle actin. This neoplasm should be included in the differential diagnosis of cervical mass lesions. This tumor also needs to be differentiated from other mesenchymal lesions of lower female genital tract.

Keywords: Myofibroblastoma; cervix; immunohistochemistry; pathology.

Figure 1.

(a) and (b) A 3.8 cm well-circumscribed submucosal mass lesion involves the anterior lip of cervix and has yellow-tan and gelatinous external and cut surfaces. No hemorrhage or necrosis is identified.

Figure 2.

(a) Neoplasm composed of relatively hypocellular ovoid, stellate to spindle-shaped cells in a patternless distribution in an edematous to myxoid, variably collagenized, and vascularized stroma. The vessels range from thick walled to capillaries some of which irregularly stag-horn shaped (H&E 50×). (b) and (c) Individual neoplastic cells are mostly stellate with bland to mildly pleomorphic hyperchromatic ovoid to spindle nuclei. No epithelioid, multinucleated, or perivascular cuffing by tumor cells is seen. No anaplasia or mitosis was identified (H&E 200×).

Figure 3.

Neoplastic cells exhibited diffuse immunopositivity for desmin in spindle and stellate lesional cells: (a) desmin 50× and (b and c) desmin 200×.

Figure 4.

Staining with CD34 was positive in a large subset of spindle and stellate cells (CD34 200×).

Figure 5.

Smooth muscle actin staining was positive in a small subset of cells (SMA 200×).

Figures 6.

Two age-matched and site-matched (anterior) non-neoplastic cervix sections from unrelated cases used as controls: (a and b) H&E 200×, (c and d) desmin 50×, and (e and f) desmin 200×.