Récidive d’un angiomyxome périnéal agressif : une chirurgie d’exérèse incomplète est-elle utile ?

Aggressive angiomyxoma of the pelvis and abdominal wall: Dramatic response to chemical ablation therapy

Objective

Aggressive angiomyxoma (AAM) is a rare, locally aggressive soft tissue neoplasm with a marked tendency for local recurrence after surgery. Although hormone therapy, radiation therapy, and vascular embolization can be performed, we investigated the safety and efficacy of a new chemical ablation protocol for AAM.

Methods

This study included two female AAM patients from 2012 to 2016. The patients’ clinical and imaging data were collected. The amount of anhydrous ethanol and glacial acetic acid used for chemical ablation was documented, and the management of any complications was detailed.

Results

The maximum dimensions of the residual tumor were 12.6 cm and 14.0 cm. In one case, the lesion was in the pelvis and protruded into the vulva. Eighty milliliters of liquid with a mixture of glacial acetic acid, anhydrous ethanol, and iohexol (10:9:1) was used for chemical ablation therapy via multipoint injections with a single needle. However, a pelvic fistula developed 1 month later. In another case, the lesion was located in the abdominal wall. The ablation procedure was improved by performing chemical ablation therapy with multiple needles for multi-point injections of smaller than 30 ml injections for each procedure. To date, no recurrence or metastasis has been observed in the two cases.

Conclusion

The preferred treatment for AAM is complete resection. Chemical ablation therapy is a novel adjuvant therapy for AMM. Nonetheless, more research is needed to confirm these findings.

Angiomyofibroblastoma-like tumor of the scrotum: A case report and literature review

The purpose of the present study was to increase the knowledge of angiomyofibroblastoma (AMF)-like tumors in males by describing the second case of this rare lesion in the Chinese population with a long period of follow-up and by reviewing the literature. AMF-like tumor is a rare, circumscribed, slow-growing mesenchymal tumor that occurs predominantly in the vulva, perineum and pelvis of females. The present report presents a case of left scrotal AMF-like tumor in a 37-year-old male. Complete surgical excision was performed. The tumor was composed of spindle-shaped cells and small vessels proliferating in the edematous stroma. Immunohistologically, the tumor cells stained positive for smooth muscle actin and negative for S-100, CD34 and actin. Following seven years of follow-up the patient was asymptomatic and no evidence of tumor was found. In addition, the current literature was reviewed and the characteristics of this tumor were summarized. AMF-like tumors must also be distinguished from spindle cell lipoma, solitary fibrous tumor and aggressive angiomyxoma.