Moreover, the optimal duration of therapy is unknown. Microscopically, these tumors have low to moderate cellularity. The external iliac artery was intact. Given their propensity for local recurrence, differential diagnoses should be done for multiple benign myxoid lesions, even though clinical, microscopic and immunohistochemical characteristics are shared by several types of tumors. Angiography usually reveals a hypervascular mass occasionally accompanied by feeder vessels 9,
Immunohistochemically, the cells show positive staining with vimentin, desmin, estrogen, and progesterone receptor. A year-old female patient who previously underwent surgery for left femoral hernia operation resulting in surgical failure was reoperated for a giant AA located in the pelvis. Mitosis was not observed. Macroscopically, AA has a gelatinous appearance, and it is microscopically characterized by a myxoid stroma and abundant thin-thick walled vascular channels [ 1 , 6 ]. The tumor has exerted pressure on the bladder, the left ureter, uterus, and left iliac vein. According to the histopathological and immunohistochemical findings, the case was interpreted as intra-abdominal aggressive angiomyxoma. Int J Gynecol Cancer ;
Surgery is undoubtedly the most important radical method for treating this disease. Aggressive angiomyxoma AA is a rare pelvic soft-tissue tumor often found in the perineum which originates from myocardial annd. Journal of Medical Case Reports ; 4: In the absence of sufficient studies hormone therapy cannot replace surgery. Juan Fernando Medina R. Rev Med Hosp Gen Mex ; 70 2: The origin of the tumor may act like a wound healing situation and this may be the reason of its locally invasive character.
Both studies can accurately determine the extent invasive edge and the relationship to adjacent organs of the tumor and whether or not the tumor passes through the pelvic diaphragm. Hence, we aimed to contribute our case to the literature by presenting the surgical outcome of a patient who underwent radical surgery for angiomyoxma giant AA.
This is the best accepted hypothesis for their origins 1, 3, 6, Angiomixoma agresivo en hombres. Because they are rare, their incidence has not been clearly established 1but about cases have been described in the medical literature to date. Unfortunately, the highest recurrence rates after resection still remain a major surgical problem that should be solved.
The patient displays no evidence of local recurrence for 2 years postoperatively. Aggressive angiomyxoma AA is an uncommon mesenchymal tumor which is predominantly encountered among adult females in reproductive age [ 1 ].
Aggressive angiomyxoma: A case series and literature review
The tumor was completely excised with free margins. Indexed in Web of Science.
Although it is previously regarded as a nonmetastasizing tumor, its metastatic potential has been revealed in a few recent reports [ 45 ].
Currently the patient has completed 8 months without disease and remains under clinical monitoring by the Coloproctology and Oncology services of the hospital. Journal of Clinical Oncology ; A patient of 2 years old is the youngest reported in the literature to date 2, FOLLOW-UP Follow-up examinations at intervals of one to two years in which ultrasound and MRI examinations are alternated are sufficient, given the slow growth and low likelihood of metastasis of this tumor 3.
Aggressive angiomyxoma: a case series and literature review.
Currently this translocation is considered to be the most common chromosomal abnormality associated with the emergence of human mesenchymal neoplasms, and thus HMGA2 cannot be used as a specific marker for aggressive angiomyxoma. Several beneficial results with tamoxifen lliterature gonadotropin-releasing hormone GnRH agonist have been described [ 1917 ]. The mass was also extended to the one-third upper level of left thigh.
Complete resection is considered to be the treatment of choice for primary tumors and for recurrences6, 7, The tumor was invading adjacent soft literaature including adipose tissue, muscles, and nerves. The most common clinical symptom is painless swelling at vulva or groin area.
Monitoring includes periodic MRI imaging which has ruled out tumor recurrence to date. In women it is most commonly found in the perineum and pelvic organs including the bladder and uterus 3. AA is an uncommon mesenchymal tumor which is mostly derived from the pelvic and perineal regions including vulva, vagina, bladder, and rectum [ 168 ]. According to our view, reporting case series of these tumors may lead to a better understanding of how AA behaves. Although it is almost exclusively encountered among females in reproductive age, rare anhiomyxoma have been diagnosed in the perimenopausal female, children, and male patients [ 7 ].
MD 2Heinz O. Including broad free margins around the tumor in the area of resection should be the first step in preventing recurrences of this lesions, although this depends on tumor size, location and the presence or absence of disease within the surgical margin 1, 2, 6, 8.