Archives of Gynecology and Obstetrics

, Volume 277, Issue 6, pp 483–487 | Cite as

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

  • Inge Dierickx
  • Karen Deraedt
  • Willy Poppe
  • Jasper Verguts
Review Article

Abstract

Background

Aggressive angiomyxoma (AA) is a rare vulvovaginal mesenchymal neoplasm with a marked tendency to local recurrence but which usually does not metastasize.

Case report

We describe a case of AA in the left labium majus pudendi in a 47-year-old woman who underwent incomplete surgical excision. Follow-up 2 years later revealed no recurrence.

Conclusion

In the past, most authors advocated wide excision even if genitourinary and digestive tract resection were necessary. These days, a less radical surgery is recommended, but the significance of hormonal treatment and/or radiation therapy is not clear yet. Further investigation is necessary.

Keywords

Aggressive angiomyxoma Vulva Treatment 

References

  1. 1.
    Steeper TA (1983) Aggressive angiomyxoma of the female pelvis and perineum: report of nine cases of an distinctive type of gynaecologic soft-tissue neoplasm. Am J Surg Pathol 7:463–475PubMedCrossRefGoogle Scholar
  2. 2.
    Magtibay PM, Salmon Z, Keeney GL, Podratz KC (2006) Aggressive angiomyxoma of the female pelvis and perineum: a case series. Int J Gynecol Cancer 16:396–401PubMedCrossRefGoogle Scholar
  3. 3.
    Chan YM, Hon E, Ngai SW, Ng TY, Wong LC, Chan IM (2000) Aggressive angiomyxoma in females: is radical resection the only option? Acta Obstet Gynecol Scand 79:216–220PubMedCrossRefGoogle Scholar
  4. 4.
    Fetsch JF, Laskin WB, Lefkowitz M, Kindblom LG, Meis-Kindblom JM (1996) Aggressive angiomyxoma: a clinicopathologic study of 29 female patients. Cancer 78:79–90PubMedCrossRefGoogle Scholar
  5. 5.
    Behranwala KA, Thomas JM (2003) Aggressive angiomyxoma: a distinct clinical entity. Eur J Surg Oncol 29:559–563PubMedCrossRefGoogle Scholar
  6. 6.
    Smith HO, Worrell RV, Smith AY, Dorin MH, Rosenberg RD, Bartow SA (1991) Aggressive angiomyxoma of the female pelvis and perineum: review of the literature. Gynecol Oncol 42:79–85PubMedCrossRefGoogle Scholar
  7. 7.
    Han-Geurts IJM, van Geel AN, van Doorn L, den Bakker M, Eggermont AMM, Verhoef C (2006) Aggressive angiomyxoma: multimodality treatments can avoid mutilating surgery. J Cancer Surg 32:1217–1221Google Scholar
  8. 8.
    Nucci MR (2000) Vulvovaginal soft tissue tumours: update and review. Histopathology 36:97–108PubMedCrossRefGoogle Scholar
  9. 9.
    Chen L, Schink JC, Panares BN, Barbuto D, Lagasse LD (1998) Resection of a giant aggressive angiomyxoma in the Philippines. Gynecol Oncol 70:435–439PubMedCrossRefGoogle Scholar
  10. 10.
    Rotmensch EJ, Kasznica J, Hamid MA (1983) Immunohistochemical analysis of hormone receptors and proliferating cell nuclear antigen in aggressive angiomyxoma of the vulva. Int J Gynecol Obstet 41:171–179CrossRefGoogle Scholar
  11. 11.
    Granter SR, Nucci MR, Fletcher CDM (1997) Aggressive angiomyxoma: reappraisal of its relationship to angiomyofibroblastoma in a series of 16 cases. Histopathology 30:3–10PubMedCrossRefGoogle Scholar
  12. 12.
    Nemoto T, Shinoda M, Komatsuzaki K, et al (1994) Myxoid leiomyomas of the vulva mimicking aggressive angiomyxoma. Pathol Int 44:454–459PubMedGoogle Scholar
  13. 13.
    Siassi RM (1992) Metastasizing aggressive angiomyxoma. N Engl J Med 2:1772Google Scholar
  14. 14.
    Blandamura S, Cruz J, Faure Vergara L, Machado Puerto I, Ninfo V (2003) Aggressive angiomyxoma: a second case of metastasis with patient’s death. Hum Pathol 34:1072–1074PubMedCrossRefGoogle Scholar
  15. 15.
    Begin LR, Clement PB, Kirk ME, Jotny S, McCaugney WTE, Ferenczy A (1985) Aggressive angiomyxoma of pelvic soft parts. Hum Pathol 16:621–628PubMedCrossRefGoogle Scholar
  16. 16.
    Amezcua CA, Begley SJ, Mata N, Felix JC, Ballard CA (2005) Aggressive angiomyxoma of the female tract: a clinicopathologic and immunohistochemical study of 12 cases. Int J Gynecol Cancer 15:140–145PubMedCrossRefGoogle Scholar
  17. 17.
    van Roggen JF, van Unnik JA, Briaire-de Bruijn IH, Hogendoorn PC (2005) Aggressive angiomyxoma: a clinicopathological and immunohistochemical study of 11 cases with long-term follow-up. Virchows Arch Pathol Anat Physiol Klin Med 446:157–163Google Scholar
  18. 18.
    McCluggage WG, Patterson A, Maxwell P (2000) Aggressive angiomyxoma of pelvic parts exhibits oestrogen and progesterone receptor positivity. J Clin Pathol 53:603–605PubMedCrossRefGoogle Scholar
  19. 19.
    Mascarenhas L, Knaggs J, Clark J, Eliot B (1993) Aggressive angiomyxoma of the female pelvis and perineum: case report and literature review. Am J Obstet Gynecol 169:555–556PubMedGoogle Scholar
  20. 20.
    Han-Ching L, Chia-Chu L, Wan-Yi K, et al (2006) Huge aggressive angiomyxoma: a case report and literature review. Kaohsiung J Med Sci 22(6):301–303CrossRefGoogle Scholar
  21. 21.
    Amr SS, el-Mallah KO (1995) Aggressive angiomyxoma of the vagina. Int J Gynaecol Obstet 48:207–210PubMedCrossRefGoogle Scholar
  22. 22.
    Yaghoobian J, Zinn D, Ramanathan K, Pinck RL, Hilfer J (1987) Ultrasound and computed tomographic findings in aggressive angiomyxoma of the uterine cervix. J Ultrasound Med 6:209–212PubMedGoogle Scholar
  23. 23.
    Dragoumis K, Drevelengas A, et al (2005) Aggressive angiomyxoma of the vulva extending into the pelvis: report of two cases. J Obstet Gynaecol 31(4):310–313Google Scholar
  24. 24.
    Outwater EK, Marchetto BE, Wagner BJ, Siegelman ES (1999). Aggressive angiomyxoma: findings on CT and MR imaging. AJR Am J Roentgenol 172:435–438PubMedGoogle Scholar
  25. 25.
    Stewart ST, McCarthy SM (2004) Case 77: aggressive angiomyxoma. Radiology 233:697–700PubMedCrossRefGoogle Scholar
  26. 26.
    Steiner E, Schadmand-Fischer S, Schunk K, Bezzi I, Weikel W, Pilch H, Knapstein PG (2001) Perineal excision of a large angiomyxoma in a young woman following magnetic resonance and angiographic imaging. Gynecol Oncol 82(3):568–570PubMedCrossRefGoogle Scholar
  27. 27.
    Fishman A, Otey LP, Poindexter AN 3rd, Shannon RL, Girtanner RE, Kaplan AL (1995) Aggressive angiomyxoma of the pelvis and perineum. A case report. J Reprod Med 40(9):665–669PubMedGoogle Scholar
  28. 28.
    Simo M, Zapata C, Esquius J, Domingo J (1992) Aggressive angiomyxoma of the female pelvis and perineum: report of two cases and review of the literature. Br J Obstet Gynaecol 99:925–927PubMedGoogle Scholar
  29. 29.
    Poirier M, Fraser R, Meterissian S (2003) Unusual abdominal and pelvic tumors: case 1. aggressive angiomyxoma of the pelvis: response to luteinizing hormone-releasing hormone agonist. J Clin Oncol 18:3535–3536CrossRefGoogle Scholar
  30. 30.
    McCluggage WG, Jamieson T, Dobbs SP, Grey A (2006) Aggressive angiomyxoma of the vulva: dramatic response to gonadotropin-releasing hormone agonist therapy. Gynecol Oncol 100:623–625PubMedCrossRefGoogle Scholar
  31. 31.
    Brooks SE, Balidimos KL, Reuter KL, Khan A (1998) Virtual consult: aggressive angiomyxoma of the vulva: impact of GnRH agonists. Medscape Womens Health 3:1–5Google Scholar
  32. 32.
    Fine BA, Munoz AK, Litz CE, Gershenson DM (2001) Primary medical management of recurrent aggressive angiomyxoma of the vulva with a gonadotropin-releasing hormone agonist. Gynecol Oncol 81:120–122PubMedCrossRefGoogle Scholar
  33. 33.
    Shinohara N, Nonomura K, Ishikawa S, Seki H, Koyanagi T (2004) Medical management of recurrent aggressive angiomyxoma with gonadotropin-relaesing hormone agonist. Int J Urol 11:432–435PubMedCrossRefGoogle Scholar
  34. 34.
    Fine BA, Munoz AK, Litz CE, Gershenson DM (2001) Primary medical management of recurrent aggressive angiomyxoma of the vulva with a gonadotropin-releasing hormone agonist. Gynecol Oncol 81:120–122PubMedCrossRefGoogle Scholar
  35. 35.
    Magtibay PM, Salmon Z, Keeney GL, Podratz KC (2006). Aggressive angiomyxoma of the female pelvis and perineum: a case series. Int J Gynecol Cancer 16:396–401PubMedCrossRefGoogle Scholar
  36. 36.
    Dove S, et al Unusual female pelvic tumour: aggressive angiomyxoma. Eur J Obstet Gynecol (in press)Google Scholar
  37. 37.
    Rhomberg W, Jasarevic Z, Alton R (2000) Aggressive angiomyxoma of the pelvis: irradiation for recurrent disease. Strahlenther Onkol 176:324–326PubMedCrossRefGoogle Scholar
  38. 38.
    Nyam DCNK, Pemberton JH (1998) Large aggressive angiomyxoma of the perineum and pelvis: an alternative approach: report of a case. Dis Colon Rectum 41:514–6516PubMedCrossRefGoogle Scholar
  39. 39.
    Behranwala KA, Thomas JM (2003) “Aggressive” angiomyxoma: a distinct clinical entity. Eur J Surg Oncol 29(7):559–563PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Inge Dierickx
    • 1
  • Karen Deraedt
    • 2
  • Willy Poppe
    • 1
  • Jasper Verguts
    • 1
    • 3
  1. 1.Department of Obstetrics and GynaecologyKatholieke Universiteit LeuvenLeuvenBelgium
  2. 2.Department of PathologyKatholieke Universiteit LeuvenLeuvenBelgium
  3. 3.Department of Obstetrics and GynaecologyUniversity Hospital GasthuisbergLeuvenBelgium

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