AGGRESSIVE ANGIOMYXOMA A CASE SERIES AND LITERATURE REVIEW
Angiomixoma agresivo en hombres. Among women sites which are frequently involved include the vulva, the vagina, the groin, the buttocks and the peritoneum, but it has also been described in the oral cavity, the uterus, the cervix, the bladder and the pararenal space 4, 7, Case Reports in Surgery. A year-old nulliparous female patient with a previous history of left femoral hernia operation was admitted to our hospital. Management requires complete removal of the lesion and the clinical and imaging follow-up given their high rate of recurrence. Macroscopically, tumors are usually firm or gelatinous with diameters of 10 cm or more.
Also, due to the high rate of local recurrence, follow-up examinations with MRI and ultrasound alternating at intervals of one to two years should be sufficient. The initial physical examination confirmed the presence of a soft 8 x 5 cm mass with ill-defined edges in the right central gluteus. Also, the tumor size is not correlated with recurrence. Aggressive angiomyxoma occurs much more frequently among women than in men, among whom it is rare. This uncommon neoplasm presents no typical universal symptoms but rather presents a wide variety of clinical signs 2.
There is only one study evaluating the pathogenesis of AA in the current literature in which Nucci and Fletcher [ 15 ] suggested a translocation at the level of chromosome 12 where the high mobility group protein HMGA2 a transcription factor expressed during embryogenesis is located.
Patients experience dyspareunia and a sensation of mass in the pelvis or abdomen which increases when heavy objects are lifted 5, 6.
Aggressive angiomyxoma: a case series and literature review.
View at Google Scholar J. The reported age of presentation ranges from 1 to 82 years, with a median age of 33 years [ 67 ]. Angiography usually reveals a hypervascular mass occasionally accompanied by feeder vessels 9, Incomplete or partial resection may lead to high recurrence rates.
Chemotherapy and radiation therapy are considered to be inadequate adjuvant therapies following surgical removal of aggressive angiomyxoma due to the low mitotic activity angiomyyxoma neoplastic cells and because angiomyxoma has almost no potential for metastasis 2, 4, 6, 7, It most frequently involves the pelvic and perineal region of women during reproductive age and is uncommon among men.
Physical examination often underestimates the total extent of angiomyxoma except for cases of small vaginal or vulvar lesions 6. However, there is still a debate about the treatment because of literrature recurrence rates in spite of wide surgical excision. In the absence of sufficient studies hormone therapy cannot replace surgery. Recurrence has been developed mostly within the first 3 years litegature 14 ].
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Aggressive angiomyxoma: A case series and literature review
Until we have more information these chromosomal findings are not uniform in any way, but rather mere curiosities10, 11, 14, AA is regarded as an aggressive tumor due to the neoplastic nature of the blood vessels and its high tendency of local infiltration and aggrsesive recurrence.
All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License. Int J Gynecol Pathol ; 25 litwrature Elliott McCaughey, and A. The initial physical examination confirmed the presence of a soft 8 x 5 cm mass with ill-defined edges in the right central gluteus.
Management requires complete removal of the lesion and the literwture and imaging follow-up given their high rate of recurrence. Two factors may contribute to the high rate of local recurrence.
Chemotherapy yields no beneficial results for adjuvant therapy because of low mitotic activity of the tumor. However, long-term use of these drugs is still controversial because of their adverse effects.
Moreover, the optimal duration of therapy is unknown. Laparotomy was performed through a midline incision that extends to the left thigh. Presacral lesion after extraction.
Because of its rarity, the clinical presentation and the treatment method of the tumor have been described mostly based on individual case presentations. Aggressive Angiomyxoma in men. Laparoscopic surgery for pelvic tumors in the ischioanal area has been reported. Second, the strategic location of the tumor around the urethra, vagina, anal sphincter and rectum with extensions above and below the pelvic diaphragm makes complete resection difficult and does not allow either an exclusively abdominal or an exclusively perineal approach.
Rev Med Hosp Gen Mex ; 70 2: The use of CAT scans or MRIs is essential for definition of tumor size especially since size is usually not clinically apparent in cases where there are extensions from the perineum into the pelvis. The patient displays no evidence of local recurrence for 2 years postoperatively.
The tumor usually arises from the pelvic and perineal regions; however, uncommon localization has been reported in the literature [ 23 ]. Clinically measurable response requires 3 to 4 months 2, 6, 10, 14,