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Baek, Lim, and Bae: Cellular Angiofibroma of the Perianal Space: MR Imaging and Pathologic Correlation
Case Report
Journal of the Korean Society of Magnetic Resonance in Medicine

Journal of the Korean Society of Magnetic Resonance in Medicine 2011; 15(3): 262-266.

Published online: 31 December 2011

DOI: https://doi.org/10.13104/jksmrm.2011.15.3.262

Cellular Angiofibroma of the Perianal Space: MR Imaging and Pathologic Correlation

Chang-Kyu Baek1, Joon Seok Lim1, Yoon Sung Bae2

1Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Korea.

2Department of Pathology, Yonsei University College of Medicine, Korea.

Address reprint requests to: Joon Seok Lim, M.D., Ph.D., Department of Radiology, Yonsei University College of Medicine, 250 Seongsan-no, Seodaemun-gu, Seoul 120-752, Korea. Tel. 82-2-2228-7400, Fax. 82-2-393-3035, jslim1@yuhs.ac

Received 22 June 2011       Revised 23 September 2011       Accepted 13 December 2011

Copyright © 2011 Korean Society of Magnetic Resonance in Medicine

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A variety of benign and malignant tumor can occur in the perianal space. Among them, cellular angiofibroma is a rare tumor that belongs to fibroblastic/myofibroblastic tumors of the WHO classification, sometimes called as "angiomyofibroblastoma-like tumor". Cellular angiofibroma can be found at various anatomic sites such as the vulva, perineum, genital tract, and inguinal regions with approximately equal gender ratio. This tumor is usually a well-circumscribed mass showing isosignal intensity to muscle on T1-weighted images. On T2-weighted images, cellular angiofibroma may show as a mass with inhomogeneous signal intensity depending on amount of composed spindle cell, collagenous stroma, myxoid matrix, and fat tissue; however it is characterized by low signal intensity due to fibrous tissues. This highly vascular mass shows strong enhancement on post contrast images. Recommended treatment is simple local excision and no recurrence or metastasis have been reported up to date.

Keywords: Cellular angiofibroma, Perianal space, Magnetic resonance imaging (MRI)

Figures and Tables

Fig. 1
A 43-year-old man with cellular angiofibroma. (a) Axial precontrast CT image shows an oval shaped mass in the left side perirectal space. (b) On axial postcontrast CT image, the mass shows heterogeneous enhancement. (c) Axial T1-weighted fast spin echo image shows iso-signal intense mass to the surrounding muscles. (d) On axial T2-weighted image, the mass shows internal heterogeneous signal intensity with hypointense peripheral rim. (e) Axial pre-contrast fat suppressed T1-weighted image shows iso-intense mass. (f) On post-contrast axial fat suppressed T1-weighted image, the mass shows well enhancement. (g) F-18 FDG PET-CT shows a mildly increased FDG uptake of the mass and no other abnormally increased FDG uptaken lesion to suggest lymph node involvement or distant metastasis (not shown). (h) On gross sections, the cut surface shows homogeneous partly lobulated grayish appearance with encapsulation. (i) Photomicrograph reveals a well defined mass with numerous thin-walled vascular channels (H & E, Magnification, ×40). (j) Photomicrograph reveals a proliferation of short spindle cells with numerous thin-walled vascular channels in the background of abundant collagenous stroma (H & E, Magnification, ×200).
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