AGGRESSIVE ANGIOMYXOMA A CASE SERIES AND LITERATURE REVIEW
In differential diagnosis among angiomyxoma, myxoid liposarcoma and myxoma for these patients, patients with angiomyxoma should test positive for vimentin and negative for S protein Most are diagnosed in the first two to three years after initial surgery with average recurrence time between 9 and 14 months following surgery 2, , 9, 11, 12, She was initially diagnosed as a femoral hernia and underwent surgery one month ago at another state hospital. It is likely due to the loose myxoid matrix and high-water content of AA [ 8 ]. Recognition of presacral lesion by MRI.
Many studies have described encouraging results from the use of a single monthly 3. Another important characteristic is that these lesions form masses that displace rather than infiltrate adjacent structures 3, 9. Unfortunately, the highest recurrence rates after resection still remain a major surgical problem that should be solved. The mitotic activity was not observed. It is locally aggressive and metastasizes quickly and easily. View at Google Scholar I. Chemotherapy and radiation therapy are considered to be inadequate adjuvant therapies following surgical removal of aggressive angiomyxoma due to the low mitotic activity of neoplastic cells and because angiomyxoma has almost no potential for metastasis 2, 4, 6, 7,
Services on Demand Article. It is notable that preoperative imaging has a crucial importance in the diagnosis of AA. Aggressive Angiomyxoma of the Male Genital Region.
The pathogenesis of AA is not well understood.
Aggressive angiomyxoma in men: Clinical case report and literature review
Moreover, the optimal duration of therapy is unknown. This high recurrence rate has been attributed to incomplete surgical excision since residual tumors are the main determinant of recurrence 2, 9, Complete surgical excision with tumor-free margins is still accepted as the main treatment method for AA [ 1 — 9 ]. Respecting this view, we believe that it is not compatible with the oncological principles. Physical examination often underestimates the total extent of angiomyxoma except for cases of small vaginal or vulvar lesions 6.
Aggressive angiomyxomas are extremely rare. The principle treatment should be complete surgical excision with tumor-free margins. Int J Gynecol Cancer ; It has been established that fewer than of the cases were reported in the English language literature between and 2. Histopathologic examination of the tumor. Report of a Case and Review of the Literature. This established the diagnosis of a presacral tumor Figure 1. Patients experience dyspareunia and a sensation of mass in the pelvis or abdomen which increases when heavy objects are lifted 5, 6.
In general, these lesions occur in the pelvis, perineum and inguinal region Also, the tumor size is not correlated with recurrence.
It is locally aggressive and metastasizes quickly and easily. The initial physical examination confirmed the presence of a soft 8 x 5 ligerature mass with ill-defined edges in the right central gluteus.
Aggressive angiomyxoma: A case series and literature review
In view of these data, the demographic characteristic and the tumor localization of our patient were angiomyoxma to the majority of previously reported cases. Administered prior to surgery it reduces tumor extension and thus reduces resulting morbidity 2, 8. 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.
Zuur and The Language Workshop Received: Whether or androgen agonists should be used to treat male patients who test positive for androgen receptors has not yet been determined 2. The tumor was completely excised with free margins. The tumor was invading adjacent soft tissue including adipose tissue, muscles, and nerves.
Ann R Coll Surg Engl ; The mass was also extended to the one-third upper level of left thigh. USG reveals hypoechoic cystic mass and usually remains insufficient for diagnosis. Complete resection is considered to be the treatment of choice for primary tumors and for recurrences6, 7, The tumor was extending to the left thigh via canal of Nuck. Macroscopically, tumors are usually firm or gelatinous with diameters of 10 cm or more.
Morphologically, the tumor was composed of spindled and stellate-shaped cells with ill-defined cytoplasm intermingled with collagen fibers and thin vessels in a myxoid background.