Aggressive angiomyxoma of the vulva: a case report and review of literature
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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 TreatmentReferences
- 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.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.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.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.Behranwala KA, Thomas JM (2003) Aggressive angiomyxoma: a distinct clinical entity. Eur J Surg Oncol 29:559–563PubMedCrossRefGoogle Scholar
- 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.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.Nucci MR (2000) Vulvovaginal soft tissue tumours: update and review. Histopathology 36:97–108PubMedCrossRefGoogle Scholar
- 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.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.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.Nemoto T, Shinoda M, Komatsuzaki K, et al (1994) Myxoid leiomyomas of the vulva mimicking aggressive angiomyxoma. Pathol Int 44:454–459PubMedGoogle Scholar
- 13.Siassi RM (1992) Metastasizing aggressive angiomyxoma. N Engl J Med 2:1772Google Scholar
- 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.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.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.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.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.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.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.Amr SS, el-Mallah KO (1995) Aggressive angiomyxoma of the vagina. Int J Gynaecol Obstet 48:207–210PubMedCrossRefGoogle Scholar
- 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.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.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.Stewart ST, McCarthy SM (2004) Case 77: aggressive angiomyxoma. Radiology 233:697–700PubMedCrossRefGoogle Scholar
- 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.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.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.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.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.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.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.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.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.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.Dove S, et al Unusual female pelvic tumour: aggressive angiomyxoma. Eur J Obstet Gynecol (in press)Google Scholar
- 37.Rhomberg W, Jasarevic Z, Alton R (2000) Aggressive angiomyxoma of the pelvis: irradiation for recurrent disease. Strahlenther Onkol 176:324–326PubMedCrossRefGoogle Scholar
- 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.Behranwala KA, Thomas JM (2003) “Aggressive” angiomyxoma: a distinct clinical entity. Eur J Surg Oncol 29(7):559–563PubMedCrossRefGoogle Scholar
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