The Incidental Aggressive Angiomyxoma of the Vulva: Looks can be Deceptive

Aggressive angiomyxoma is a benign, slow-growing, locally aggressive tumor of mesenchymal origin primarily occurring in the pelvic–perineal regions of reproductive age group women and displays a high risk of local recurrence. Lack of specific symptomatology and overlap with other benign and malignant vulval masses makes it a diagnostic challenge. We describe the case of a 32-year-old nulliparous woman with a history of recurrent vulval abscess requiring multiple incision and drainage procedures before she presented to us with an actively draining abscess on the upper third of the left labia majora. She underwent excisional biopsy at our center, the histopathology of which revealed aggressive angiomyxoma with secondary pyogenic slough. The preoperative diagnosis of vulval aggressive angiomyxoma becomes challenging due to the absence of diagnostic features. It ought to be considered a differential in every perineal–pelvic region mass in adult women.