Cellular angiofibroma (CAF) is a rare tumor of mesenchymal origin and is benign in nature. It mostly occurs in the genital region of both males and females. The condition has predilection for female vulvo-vaginal region. Histologically, the CAF is characterized by presence of bland spindle-shaped cells along with numerous small- to medium-sized vessels with mural hyalinization.

A 61-year-old postmenopausal woman presented undergoing treatment for ductal carcinoma of breast presented with the complaint of postmenopausal bleeding of short duration. Pelvic examination revealed a polypoidal mass of around 2*1.5 cm, firm in consistency and thick pedicle arising from middle one-third of posterior vaginal wall. Co-testing with Pap and HPV for cervical cancer screening was negative. On ultrasonography of pelvis, endometrial thickness was 8 mm and rest of the findings were normal. The patients underwent fractional curettage and removal of vaginal tumor. The histopathology of specimen confirmed the diagnosis of vaginal cellular angiofibroma.

CAF is a rare entity with unknown etiopathogenesis. Surgery is the definitive treatment option. The diagnosis is based on histopathological examination of surgical specimen, and sometimes immunohistochemistry is required to confirm the diagnosis although a benign condition follow-up is required to look for recurrence.