Rare soft tissue tumor presenting as inguinal swelling

Cellular angiofibroma (CAF) is a rare, benign mesenchymal tumor found usually in the female vulvar and male inguinoscrotal regions. A 56-year-old Caucasian gentleman presented with left sided scrotal swelling after masturbating. The swelling was thought to be an inguinal hernia, although was found to be a soft tissue tumor upon dedicated cross-sectional imaging. Pathological evaluation of the mass revealed it to be a cellular angiofibroma. Diagnosis of CAF can only be made after resection and proper immunohistological staining. Ultrasonography and MRI are preferred for detailed soft tissue characterization. After surgical resection, follow-up imaging is recommended given potential risk of malignancy.