Aggressive angiomyxoma of the liver: a case report and literature review

Prostatic aggressive angiomyxoma (AAM) with initial presentation of urinary obstruction: a rare case report and literature review

Background

Aggressive angiomyxoma (AAM) is a rare benign mesenchymal tumor known for its aggressive behavior and high recurrence rates, with male cases of AAM being less frequently reported. This study presents a rare case of primary prostatic AAM characterized by a prostatic urethral mass obstructing the bladder outlet, resulting in acute renal dysfunction.

Case Description

The 51-year-old male patient presented with lumbar pain, nausea, frequent urination, urgency, and incomplete urination. Laboratory test indicated increased levels of serum creatinine and potassium. Emergency bedside ultrasound found giant bilateral hydronephrosis. The patient received emergent potassium-lowering therapy and bilateral nephrostomy. Computed tomography (CT) revealed a 3.7 cm × 2.3 cm low-density soft tissue mass in prostate. Transurethral resection of the prostatic mass was performed. Pathological examination identified the presence of deep-seated AAM. For fear of recurrence, he underwent radical prostatectomy. Postoperative histopathology showed no sign of residual tumor. He recovered uneventfully and is now under regular follow-up.

Conclusions

AAM is a rarely reported locally aggressive mesenchymal neoplasm characterized by high recurrence, which was even rarer in prostate. As we know, this is the first case of prostatic AAM treated by both transurethral resection and further radical resection. In this case, the tumor was completely excised surgically, but long-term follow-up is required to monitor for recurrence.

Angiomyxoma coexisting with focal nodular hyperplasia: A case report

Angiomyxoma (AM) occurs almost exclusively in the soft tissues of the pelvic and perineal regions. AM is a highly uncommon condition that can be easily misdiagnosed when it is present in other regions of the body. The current study presents a case in which AM of the liver coexisted with focal nodular hyperplasia (FNH). A 56-year-old woman presented with two space-occupying lesions of the liver without any other clinical symptoms, and it was not easy to definitively diagnose the two intrahepatic lesions by imaging examinations. Due to the low incidence of AM in the liver, precise and clear clinical information on the condition is still unavailable, and the lesion was initially misdiagnosed as other hepatic tumors preoperatively. Once a tumor resection had been performed, a histopathological examination revealed that the microscopic features of the lesions were consistent with those of AM and FNH. The patient was followed up for 1 year, and no recurrence or metastasis was found. Surgical excision is an effective treatment for AM, and long-term follow-up is essential due to the risk of recurrence. The joint presentation of AM and FNH is rare in clinical practice, and although FNH of the liver is commonly reported, the difficulty of diagnosis increases when both conditions occur at the same time. Therefore, it is necessary to assist clinicians in making informed decisions regarding diagnosis and treatment.

Vulval Aggressive Angiomyxoma in a 19 year teenager: a case report

BACKGROUND

Aggressive Angiomyxoma is a benign, slowly growing, locally aggressive and recurrent tumour that occurs in the pelvic-perineal region of females in their reproductive years. It presents as a painless, soft, gelatinous mass and metastasizes rarely. Suspicion can be made based on clinical examination and radiological imaging but final diagnosis is confirmed only after histopathology and immunohistochemistry. The choice of treatment is surgical wide local excision.

CASE PRESENTATION

We hereby present a case of a 19-year, unmarried lady, with a body mass index of 21 kg/m2, who presented with a chief complaint of painless mass in left vulva which progressively increased in size in the past one year. Clinical examination revealed a large, cauliflower like, exophytic mass of 10 cm × 10 cm size. Radiological imaging confirmed involvement of lymph nodes. Wide local excision with adequate tumour free margin and depth was used as a treatment modality. The diagnosis was confirmed via histopathological examination of the excised specimen. There is no recurrence in the patient up to date.

CONCLUSION

Aggressive Angiomyxoma is a rare tumour and it is most often misdiagnosed. This report highlights the importance of considering Aggressive Angiomyxoma as a differential diagnosis of vulval masses and the two-step surgical approach for its treatment in low resource setting.

Large Aggressive Angiomyxoma of the Liver: A Case Report and Brief Review of the Literature

Aggressive angiomyxoma (AAM) is an uncommon mesenchymal myxoid tumor that almost solely involves the soft tissues of the perineum and pelvis. An AAM originating from the liver is extremely rare. Herein, we present a case of a 45-year-old female with a large mass in the left lateral lobe of the liver. She underwent a left lateral lobe hepatectomy. The histopathology of the resected specimen showed features that were characteristic of AAM. Immunohistochemical analysis of the neoplastic cells showed reactions to antibodies against CD34, smooth muscle actin (SMA), and Ki67 (2%) and showed no reactions to antibodies against Estrogen receptor (ER), C-keratin (CK), and Desmin. The patient was subsequently diagnosed with a primary AAM of the liver. This is the largest AAM of the liver that has been reported. We hereby report these findings and review the current literature.

Rare paratesticular aggressive angiomyxoma with negative oestrogen and progesterone receptors in a male patient

Aggressive angiomyxoma (AAM) is a rare mesenchymal myxoid tumour localised to the pelvis and/or perineum in adult females in reproductive age group. AAM is very rare in males, with <50 cases described in literature, and involves scrotum, spermatic cord and perineum. It is slow growing, with a marked tendency for local recurrence after excision, but without metastatic potential. We present a rare case of a paratesticular AAM in a man aged 53 years. Tumour cells were immunoreactive for desmin, smooth muscle actin (SMA), vimentin, CD34 and were negative for S100. Unlike AAMs in females which express oestrogen receptor (ER) and/or progesterone receptor (PR) in >90% cases, the tumour cells in our case were negative for ER and PR, suggesting that the hypothesis that these markers play a role in tumour development and pathogenesis, does not apply in males. Androgen receptor positivity was noted in 2%-5% tumour cells.

A persistent mass: A case of aggressive Angiomyxoma of the vulva

We present a case of aggressive angiomyxoma of the vulva. The patient presented with a persistent, enlarging vulvar mass, initially misdiagnosed as a Bartholin gland cyst. The patient underwent wide local excision, which resulted in total resection of the mass. Final pathology was consistent with aggressive angiomyxoma, a rare soft tissue tumor with a predilection for the female pelvis. Though rare, it is important to consider in the differential diagnosis of a pelvic mass, given the locally aggressive nature of this tumor and propensity for recurrence.