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Aquino CI, Tinelli R, Libretti A, Bertinato R, Boldorini RL, Giana M, Sorrentino F, Nappi L, Remorgida V, Surico D. Aggressive Pelvic Angiomyxoma in a Patient with Twin Pregnancy: Diagnosis, Treatment, and Clinical Complications in Light of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1417. [PMID: 37629707 PMCID: PMC10456254 DOI: 10.3390/medicina59081417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023]
Abstract
(1) Background: Aggressive angiomyxoma is a mesenchymal cancer that is rare during pregnancy. It is a neoplasm that relapses and infiltrates the nearest structures. Our aim is to evaluate the management and outcomes of an observed case, in light of the current literature. (2) Methods: We observed this condition at the "Maggiore della Carità" Hospital in Novara (Italy) in a patient with an initial twin pregnancy and a suspected pelvic mass. The words "angiomyxoma" and "pregnancy" were searched on the main online scientific search sources (PubMed, Google Scholar, Scopus, WES, and Embase, etc.). (3) Results: The patient underwent surgery with a complicated follow-up, but recent negative controls. We analyzed the literature about the topic and found only 24 similar clinical cases. (4) Conclusions: Considering the current literature, it is useful to assess an aggressive angiomyxoma in the differential diagnosis of soft masses in pregnant women. The treatment of choice is surgical excision, and vaginal delivery is feasible. The therapeutic decision depends on each case.
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Affiliation(s)
- Carmen Imma Aquino
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| | - Raffaele Tinelli
- Department of Obstetrics and Gynecology, “Valle D’Itria” Hospital, Martina Franca, 74015 Taranto, Italy
| | - Alessandro Libretti
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
| | - Riccardo Bertinato
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
| | - Renzo Luciano Boldorini
- Department of Pathology, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Michele Giana
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy; (F.S.); (L.N.)
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy; (F.S.); (L.N.)
| | - Valentino Remorgida
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| | - Daniela Surico
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
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Aggressive angiomyxoma of the thigh. Skeletal Radiol 2008; 37:673-8. [PMID: 18338163 DOI: 10.1007/s00256-008-0465-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2007] [Revised: 01/16/2008] [Accepted: 01/21/2008] [Indexed: 02/02/2023]
Abstract
Aggressive angiomyxoma is a rare tumour that typically occurs in the perineum in women of reproductive age. A small number of cases occurring in men have been reported, all of which were located in the low pelvis, perineum or scrotum. While benign, the tumour is locally infiltrative and consequently has a high rate of local recurrence following surgery; therefore, accurate pre-operative diagnosis is important. The characteristic location of these tumours in the low pelvis or perineum has led to speculation that aggressive angiomyxomas arise from a mesenchymal cell that is unique to the perineum. We describe a case of aggressive angiomyxoma arising in the thigh of a 54-year-old man, which we believe is the first reported instance of this rare neoplasm occurring remote from the pelvis or perineum in a male patient. Cross-sectional imaging demonstrated a well-defined mass that had low density on CT and high intensity on fluid-sensitive MR sequences. Biopsy was non-diagnostic and excision was performed. At histological analysis, the tumour exhibited the characteristic features of aggressive angiomyxoma, with bland spindle cells and large, hyalinised blood vessels in a hypocellular myxoid matrix. Extensive immunohistochemical staining further supported the diagnosis. While the imaging features of these tumours are non-specific and suggestive of myxoid neoplasms, the diagnosis should be considered whenever biopsy of a myxoid-appearing mass yields hypocellular, non-diagnostic material, despite adequate sampling.
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