1
|
Gouveia I, Xavier M, Silva J, Martins P. Malignant tumour in pregnancy: Ewing-like sarcoma of the gluteal region. BMJ Case Rep 2024; 17:e257493. [PMID: 38649246 PMCID: PMC11043757 DOI: 10.1136/bcr-2023-257493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
We report a case of an Ewing-like sarcoma of the gluteal region with ongoing growth during the second trimester of pregnancy and noted during the third trimester. This lesion was consequently studied to infer its malignant potential. Several examinations were conducted to characterise this lesion, such as ultrasound and MR, which showed signs of tumourous invasion of the deep tissues of the gluteal region.Given that the pregnancy was at the end of the third trimester, the decision was made to schedule the delivery at 37 weeks of gestation and treat the tumour afterwards to balance maternal and fetal health.This case illustrates the need for a detailed investigation and guidance by a multidisciplinary team to provide prenatal counselling regarding a malignant tumour during pregnancy.
Collapse
Affiliation(s)
- Inês Gouveia
- Gynecology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Marta Xavier
- Gynecology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Joana Silva
- Obstetrics & Ginecology, Centro Hospitalar de Vila Nova de Gaia Espinho EPE, Vila Nova de Gaia, Portugal
| | - Pedro Martins
- Cirurgia Geral, Instituto Português de Oncologia do Porto Francisco Gentil EPE, Porto, Portugal
| |
Collapse
|
2
|
Smet C, Martins AC, Costa T. Deep (aggressive) angiomyxoma of the vulva in a pregnant woman. BMJ Case Rep 2023; 16:e254564. [PMID: 38129079 DOI: 10.1136/bcr-2023-254564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Abstract
Aggressive angiomyxoma is a rare mesenchymal tumour, which usually appears in the pelvic region of women in their reproductive age. Although benign, it is a locally infiltrative tumour with frequent recurrence. We report a case of a pregnant woman in her 30s with a vulvar aggressive angiomyxoma which was initially misdiagnosed. Features of this case are discussed, highlighting the difficulty in its diagnosis and the challenge of the follow-up and treatment of recurrences.
Collapse
Affiliation(s)
- Carolina Smet
- Obstetrics and Gynecology department, Centro Hospitalar de Lisboa Ocidental - Hospital de São Francisco Xavier, Lisboa, Portugal
| | - Ana Constâncio Martins
- Obstetrics and Gynecology department, Centro Hospitalar de Lisboa Ocidental - Hospital de São Francisco Xavier, Lisboa, Portugal
| | - Teresa Costa
- Pathological anatomy and cytology, Centro Hospitalar de Lisboa Ocidental - Hospital de Egas Moniz, Lisboa, Portugal
| |
Collapse
|
3
|
Cao Z, Miao L, Liu M, Liu W, Zhang H, Liu X, Wang J, Wang X. Aggressive angiomyxoma: The first case report in skull. Front Surg 2022; 9:985739. [PMID: 36061044 PMCID: PMC9428339 DOI: 10.3389/fsurg.2022.985739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022] Open
Abstract
Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor primarily growing in the soft tissue of the pelvis and perineum in women of reproductive age. It is a benign tumor that still has a probability of being accompanied by localized invasion. Although negative margins of resection are difficult to achieve due to the invasive nature of the tumor and the lack of a well-defined capsule, the first line of treatment for AAM is surgery. The diagnosis of AAM is difficult to make due to a lack of specific manifestations and specific tumor markers. In this study, we reported a case of aggressive angiomyxoma in a 2-year-old girl that rarely develops in the skull with craniocerebral compression. The patient initially had a mass on her head that attracted the attention of her family, and then she began to have episodic headaches. Surgery was performed after hospitalization, and the tumor recurred 1 year after the operation, around the originally affected skull.
Collapse
Affiliation(s)
- Zexin Cao
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, China
| | - Lifeng Miao
- Department of Neurosuregery, Qilu Hospital of Shandong University Dezhou Hospital (Dezhou People’s Hospital), Dezhou, China
| | - Min Liu
- Operating Room of Qilu Hospital, Shandong University, Jinan, China
| | - Wenyu Liu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, China
| | - Hengrui Zhang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, China
| | - Xuchen Liu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, China
| | - Jiwei Wang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, China
- Correspondence: Jiwei Wang Xinyu Wang
| | - Xinyu Wang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine, Shandong University and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, China
- Key Laboratory of Brain Function Remodeling, Qilu Hospital of Shandong University, Jinan, China
- Correspondence: Jiwei Wang Xinyu Wang
| |
Collapse
|
4
|
Espejo-Reina MP, Prieto-Moreno M, De-Miguel-Blanc M, Pérez-Martínez DM, Jiménez-López JS, Monís-Rodríguez S. Genital Prolapse in Pregnant Woman as a Presentation of Aggressive Angiomyxoma: Case Report and Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58010107. [PMID: 35056414 PMCID: PMC8781837 DOI: 10.3390/medicina58010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/05/2022] [Accepted: 01/07/2022] [Indexed: 11/16/2022]
Abstract
Background: Aggressive angiomyxoma is a rare entity within mesenchymal cell neoplasms, especially in pregnant women. Its main characteristic is the ability to infiltrate neighboring structures and to recur. Case Presentation: We present the case of a pregnant woman who debuted with a genital prolapse in the second trimester of pregnancy. She was diagnosed with bilateral ovarian teratomas and a pelvic mass of which the diagnosis could not be established until delivery. The route of delivery used was cesarean section since the genital prolapse behaved as a previous tumor. After the puerperium, the patient was referred for consultation to complete the study of the mass. The extension study was carried out with a negative result. The patient underwent surgery for tumor exeresis. Hormonal treatment was not administered according to the patient's preferences. Conclusions: Aggressive angiomyxoma is a benign neoplasm that should be considered in the differential diagnosis of pelvic tumors in women. In pregnant women, the vaginal route of delivery is not contraindicated as long as the tumor does not obstruct the birth canal. The definitive treatment is surgery, preferably performed in a second stage after delivery.
Collapse
Affiliation(s)
- María Pilar Espejo-Reina
- Department of Obstetrics and Gynaecology, Regional University Hospital, 29011 Malaga, Spain; (M.P.-M.); (M.D.-M.-B.); (J.S.J.-L.); (S.M.-R.)
- Correspondence:
| | - Miriam Prieto-Moreno
- Department of Obstetrics and Gynaecology, Regional University Hospital, 29011 Malaga, Spain; (M.P.-M.); (M.D.-M.-B.); (J.S.J.-L.); (S.M.-R.)
| | - Marina De-Miguel-Blanc
- Department of Obstetrics and Gynaecology, Regional University Hospital, 29011 Malaga, Spain; (M.P.-M.); (M.D.-M.-B.); (J.S.J.-L.); (S.M.-R.)
| | | | - Jesús Salvador Jiménez-López
- Department of Obstetrics and Gynaecology, Regional University Hospital, 29011 Malaga, Spain; (M.P.-M.); (M.D.-M.-B.); (J.S.J.-L.); (S.M.-R.)
| | - Susana Monís-Rodríguez
- Department of Obstetrics and Gynaecology, Regional University Hospital, 29011 Malaga, Spain; (M.P.-M.); (M.D.-M.-B.); (J.S.J.-L.); (S.M.-R.)
| |
Collapse
|
5
|
Xu H, Sun P, Xu R, Wang L, Shi Y. Aggressive angiomyxoma in pregnancy: a case report and literature review. J Int Med Res 2021; 48:300060520936414. [PMID: 32644864 PMCID: PMC7350053 DOI: 10.1177/0300060520936414] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aggressive angiomyxoma is an interstitial tumour that is often misdiagnosed and is likely to recur. There have been few reported cases of angiomyxoma in pregnant women. We report a case of a woman who was previously diagnosed with a tumour in her vulva that increased in size during both of her pregnancies and spontaneously decreased postpartum. Local excision was performed and a gonadotropin-releasing hormone agonist was administered. According to a literature review, aggressive angiomyxoma is associated with good maternal and child outcomes. Caesarean section is not the delivery method of choice, but it is indicated if the tumour is preventing vaginal birth. Treatment for angiomyxoma is mainly postpartum local resection supplemented by hormone therapy. This tumour frequently recurs and patients should undergo long-term follow-up.
Collapse
Affiliation(s)
- Haihua Xu
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Pengming Sun
- Laboratory of Gynecology Oncology, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Pengming Sun, Laboratory of Gynecologic Oncology, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, 350001 Fuzhou, Fujian, China.
| | - Rongli Xu
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lihua Wang
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuequan Shi
- Department of Imaging, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| |
Collapse
|