Cellular angiofibroma arising from the rectocutaneous fistula in an adult: A case report

Figure 1 Abdominal and pelvic computed tomography. A: A track-like lesion, approximately 6 cm × 0.7 cm in size (orange arrow) is visible, which appears to originate from between the internal and external anal sphincters, with the superior part of the lesion lying in the intersphicteric plan; B: The lower part of the lesion (orange arrow) bulged into the perineum.

Figure 2 Surgical findings. A: A thick-walled cavity was discovered, and the communicating tract was identified going medially; B: The thick-walled mass with tract-like lesion measured approximately 12 cm in length; C: The skin was closed over a Penrose drain.

Figure 3 Pathological findings. A: Grossly, the excised tumors were gray and elastic; B: Cellular angiofibroma displayed numerous thick-walled blood vessels with wall hyalinization (hematoxylin and eosin [H&E] 40 ×); C: The stroma contained small uniform short spindle-shaped cells with fusiform nuclei and pale indistinct cytoplasm (H&E 400 ×); D: Immunohistochemistry was positive for smooth muscle actin; E: Immunohistochemistry of the estrogen receptor showed focal positivity; F: Immunohistochemistry of the progesterone receptor showed focal positivity.