Table 1 Summary of scrotal AMF
From: Giant angiomyofibroblastoma of the scrotum: a case report and review of the literature
Research | Age | Main complaints | Appearance feature | Imaging features | Histopathologic features | Treatment and diagnosis | Follow up |
|---|---|---|---|---|---|---|---|
Owaidah et al., 2022 [1] | 34 | A large left testicular mass was noted without pain | Oval shape | MRI showed an indeterminate hypervascular left inguinal canal mass abutting the anterior aspect of the spermatic cord | Tumor markers, including beta-human chorionic gonadotropin, alpha-fetoprotein, and lactate dehydrogenase, were tested, all of which yielded negative results | Surgery; diagnosed as a para-testicular angiofibroma | Complete wound healing |
Zeng et al., 2022 [2] | 42 | The mass remained the same size for 4 months and the patient felt slight tenderness in the left scrotum | 6 cm × 5 cm mass | Imaging examinations showed that the mass had abundant vessels and displayed obvious progressive intensification on enhanced MRI | The tumor was rich in thin-walled, small blood vessels, and surrounded by hyperplastic spindle cells. Immunohistochemical testing showed that staining for muscle-specific actin (SMA) was positive and S100 was negative. Tumor cells were positive for desmin and CD34, and the Ki67 proliferation index was approximately 1% | The tumor was excised and diagnosed as an angiofibroma | Recovered well |
Chih-Chen et al., 2016 [3] | 89 | An enlarged, painless, left scrotal mass for 1 year | Soft tissue-like mass, approximately 4.5 cm × 6.5 cm × 6.3 cm in size | Two solid scrotal masses were identified using scrotal ultrasound as well as two well-defined masses based on abdominal and pelvic computed tomography | Immunohistochemically, the tumor markers were CD34 (+), focally positive for S-100, actin (−), desmin (−), estrogen receptor (−), progesterone receptor (−), beta-catenin (−), CD99 (−), and B-cell lymphoma 2 (−) | The tumor was excised and diagnosed as a scrotal angiofibroma | Recovered and no tumor recurrence |
Kass et al., 2019 [4] | 64 | A painless scrotal mass | Oval mass measuring 3.0 × 2.0 cm in size | A well-circumscribed, extra-testicular mass was present on ultrasonography | There was spindle cell proliferation with alternating hypocellular and hypercellular areas between the vascular channels. No mitoses were noted in these spindle cells. The spindle cells were strongly positive for CD34 and most of the tumor cell nuclei were typically and diagnostically positive for estrogen and progesterone. The SMA and S100 proteins were also positive | Diagnosed as a para-testicular AMF-like tumor that was treated surgically | Uneventful recovery from surgery |
Ding et al., 2014 [6] | 37 | A painless mass in the left scrotum gradually increased in size | A mass ~ 4 × 5 cm in size | Scrotal ultrasonography showed a mass ~ 4 × 5 cm in size in the left scrotum that was not clearly differentiated from the testis and vascularity was observed inside and around the mass | Tumor markers, such as α-fetoprotein and human chorionic gonadotropin, had normal expression. The tumor cells stained positive for smooth muscle actin and negative for S-100, CD34, and actin | The pathologic diagnosis was a left scrotal AMF-like tumor. An inguinal orchiectomy was performed | No recurrences were detected over 7 years of follow up evaluations |
Dave et al., 2023 [7] | 64 | Scrotal swelling with increased frequency of micturition | 9.38 × 4.47 × 8.11 cm in size | Scrotal ultrasonography revealed a large, non-reducible, heterogeneous mass measuring 9.38 × 4.47 × 8.11 cm in the right scrotum above the testis | Microscopically, the lesion was composed of evenly distributed hypocellular and hypercellular areas. Small-to-medium capillary-sized hyalinized blood vessels were noted in the stroma. A pathologic examination showed features of a cellular AF/AMF-like tumor, which was positive for CD34 and negative for S-100 protein, smooth muscle actin, and desmin. Mib-1 labelling index was 2–4% in the highest proliferating areas. Mast cells were distributed amidst the neoplastic cells and were highlighted by C-Kit (CD117) immunohistochemistry | A diagnosis of an angiomyofibroblastoma (AMF)-like tumor or cellular AF was rendered. A para-testicular tumor excision was performed | N/A |
Aytaç et al., 2012 [8] | 40 | A painless scrotal mass enlarged | Cut surface of the tumor measuring 6.5 × 4.5 × 2 cm | Doppler ultrasound of the scrotum revealed normal testes bilaterally and a 6 × 5 × 3 cm solid mass separate from the testis and epididymis. On magnetic resonance imaging, T1-weighted images showed hypointense and T2-weighted imaging showed hyperintense images | Spindle cells were separated by fine collagen fibers and abundant edematous background. The vascular component was prominent and haphazardly distributed throughout the tumor with irregularly thickened walls containing fibrinoid or hyalinized material. Perivascular arrangement of tumor cells with focal targeting or whirling pattern was also noted. Immunostaining of the tumor cells was strong for vimentin and smooth muscle actin (SMA) and were focally stained by desmin (Fig. 3). Additional stains were negative for cytokeratin, myogenin, S-100, estrogen, and progesterone receptor proteins. Stains for CD34 were also negative in the tumor cells but highlighted endothelial cells | The pathologic diagnosis was an angiomyofibroblastoma-like tumor. The tumor was excised | N/A |
Lee et al., 2010 [9] | 71 | A chief complaint of a 1-year history of a mass in the right scrotum | The removed tumor was 13 × 10 × 6 cm in size and had an oval shape | Scrotal ultrasonography showed a giant mass, 12 cm in size, in the right scrotum | Tumor markers, including alpha-fetoprotein, beta-human chorionic gonadotropin, and lactate dehydrogenase, were all shown to be normal. Immunohistochemical staining showed negative findings for desmin, S-100, and CD34 | Diagnosed as an angiomyofibroblastoma-like tumor that occurred in the scrotum. The tumor was excised | Recovered well with no local recurrences |