A deep giant aggressive angiomyxoma of the labia majora: A case report

Unveiling a Rare Case of a Giant Aggressive Angiomyxoma of the Perineum: Diagnostic Insights From T2-Weighted MRI

Aggressive angiomyxoma (AA) is a rare benign soft tissue tumor seen in females of the reproductive age group and involving the lower pelvis and perineal soft tissue. It is characterized by the presence of both myxoid and vascular components. We present a case of a 36-year-old female who presented with right buttock swelling. Magnetic resonance imaging (MRI) revealed a large perineal swelling suspected to be a giant AA, which was demonstrating hypocellular stroma with a myxoid background in biopsy. AA should be suspected in a female patient presented with large perineal swelling. MRI should be the investigation of choice for radiological diagnosis of this rare entity to be confirmed by a pathology report.

Aggressive angiomyxoma of the vagina: A case report and literature review

RATIONALE

Aggressive angiomyxoma (AAM) is an exceptionally rare mesenchymal tumor that predominantly manifests in the female genital organs during the reproductive age. Its rarity alone makes it a fascinating subject for study. The diagnosis of AAM necessitates differentiation from other benign or mesenchymal tumors and can be confirmed through immunohistochemistry (IHC) staining. Surgical resection is the primary treatment, and adjuvant treatment can be used as hormonal therapy with gonadotropin-releasing hormone agonists, selective estrogen receptor modulators, and aromatase inhibitors.

PATIENT CONCERNS

A 44-year-old premenopausal Korean woman presented with a growing perineal mass and frequent urination.

DIAGNOSES

Histopathological findings confirmed AAM, with IHC staining showing estrogen receptor, progesterone receptor, actin and desmin positivity, and CD34 and S100 negativity.

INTERVENTIONS

The mass was excised transvaginally under general anesthesia.

OUTCOMES

The patient showed no signs of recurrence 6 months postoperatively.

LESSONS

AAM in the vagina is a rare tumor that requires differential diagnosis using IHC staining. Previously, we reviewed reported cases and confirmed the feasibility and effectiveness of surgery as the main treatment. This might reassure us about the potential successful treatment of AAM. Adjuvant hormonal therapy with gonadotropin-releasing hormone agonists, selective estrogen receptor modulators, and aromatase inhibitors can further reduce the risk of recurrence.

Massive aggressive angiomyxoma of ischioanal region with relapse: A case report

Background

Aggressive angiomyxoma (AA) is a rare and slow-growing tumor in the pelvic and perineal regions that might develop into other perineal structures. It can present variably, ranging from a painless mass to non-specific symptoms such as dyspareunia. Due to the high relapse rate, extensive tumoral resection is reasonably required to prevent recurrences. It is also commonly confused with other conditions such as lipomas, Bartholin's gland cysts, and hernias.

Objective

A 43-yr-old female diagnosed with AA 10 yr ago was evaluated as a consequence of the tumor recurrence. She presented rare manifestations of a giant and cystic pelvic mass involving pararectal and paravaginal tissue in front of the sacrum.

Case Presentation

Although AA is a rare and slow-growing tumor, close observation is recommended due to the high relapse rate. Furthermore, extensive tumoral resection and regular follow-up can reduce morbidity in these patients.

Aggressive Angiomyxoma of the Lower Female Genital Tract: A Review of the MITO Rare Tumors Group

Aggressive angiomyxoma (AAM) is a rare, locally aggressive, myxoid mesenchymal neoplasm primarily found in the pelvic and perineal regions of young adult females. It is a slow growing and locally infiltrating tumor. Preoperative diagnosis is difficult due to the rarity of these tumors and absence of characteristic signs and symptoms. The primary management is tumor excision. Incomplete excision is common because of the infiltrating nature of the neoplasm and absence of a definite capsule. Other non- surgical modalities have been employed, such as radiotherapy, embolization, GnRH analogues or other anti-estrogenic agents. Local relapses occur in 30-40% of the cases, and often appear many years (sometimes decades) after the first excision. Occasional distant metastasis has also been reported. A limited number of cases have been reported in the literature, mostly in the form of small case series or isolated case reports. Therefore, the aim of this paper by a team of experts from the MITO rare tumors group is to review clinical findings, pathologic characteristics and outcome of patients affected by this rare condition in order to be able to offer up-to-date guidance on the management of these cases.

Aggressive Angiomyxoma of the Vulva: Which Is the Best Management Strategy? Description of a Case Report and Review of Literature of the Last Ten Years

BACKGROUND

Aggressive angiomyxoma is a rare mesenchymal tumour of the genital tract with a high incidence in women of reproductive age. The aim of our work is to understand which is the best management strategy for this condition, starting from the description of a rare case report up to the performance of a narrative review of the literature.

METHODS

We report a case of a 46-year-old woman who came to our attention because of the growth of a 10-centimetre pedunculated, non-soft, non-tender mass of the left labium majus. She underwent surgical excision, and the histologic diagnosis was aggressive angiomyxoma. Due to a lack of tumour-free margins, radicalization surgery was carried out after three months. A review of the literature of the last ten years was performed following the PRISMA statement on MEDLINE (PubMed). We obtained data from twenty-five studies describing thirty-three cases.

RESULTS

Aggressive angiomyxoma is characterized by a high recurrence rate of between 36 and 72% after surgery. There is no universal consensus about hormonal therapy, and most studies (85%) describe surgical excision followed by only clinical and radiological follow-up.

CONCLUSION

Wide surgical excision is the gold-standard treatment for aggressive angiomyxoma, succeeded by either clinical or radiological (ultrasound or MRI) follow-up.