Table of Contents Alerts. 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. There have been no reports of metastasis among men to date Embolization of the tumor has been reported as an alternative approach; however, it remains insufficient due to the extensive vascular network of the tumor. It is notable that preoperative imaging has a crucial importance in the diagnosis of AA.
Nevertheless, there have been reports of recurrences occurring up to 17 years after initial surgery. Although this finding initially suggested the use of the HMGA2 gene as a marker for this malignancy, the idea was rejected because the translocation is often shared by other mesenchymal tumors such as uterine leiomyomas, lipomas, pulmonary hamartomas, liposarcomas, and hemangiopericytomas. It reduces high levels of circulating estrogen and prevents conversion of endogenous estrogen and has achieved tumor volume reduction from transverse measurements of 8. It is locally aggressive and metastasizes quickly and easily. View at Google Scholar I. AA commonly manifests a painless swelling located around the genitofemoral region.
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Aggressive angiomyxoma in men: Clinical case report and literature review
However, there is still a debate about the treatment because of high recurrence rates in spite of wide surgical excision. Abstract Aggressive angiomyxoma AA is an uncommon mesenchymal tumor that is mostly derived from the female pelvic and perineal regions. The tumor is distinguished from other lesions by these histopathologic features.
Thus, extensive surgery can be disregarded in patients with high morbidity and for preserving fertility, as well. To date only 40 cases among men have been published 4, 10, Recurrence has been developed mostly within the first 3 years [ 14 ].
Aggressive angiomyxoma: A case series and literature review
Furthermore, considering the recently reported cases with distant metastasis, complete resection should be performed as technical as possible despite the high morbidity of the operation. Microscopically, these tumors have low to moderate cellularity. Several beneficial results with tamoxifen or gonadotropin-releasing hormone GnRH agonist have been described [ 1 angoimyxoma, 917 ]. Consequently, most cases are diagnosed incidentally, even though preoperative recognition is often quite difficult because of the rarity of the condition.
Archive ouverte HAL – Aggressive angiomyxoma: A case series and literature review
Nevertheless, longer-term follow-up using the same studies should be considered 11, Another important characteristic is that these lesions form masses that displace rather than infiltrate adjacent structures 3, 9. Scrotal aggressive angiomyxoma mimicking inguinal hernia. Case Presentation A year-old nulliparous female patient with a previous history of left femoral hernia operation was admitted to aggreszive hospital.
In view of these findings, we think that there is still a lack of knowledge about the diagnosis of AA among the clinicians. 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 angiomyxpma of metastasis of this tumor 3.
Liteerature earliest reported recurrence happened just two months after initial surgery 6, 10, They are most commonly found in pelvic locations in women.
Aggressive angiomyxoma: a case series and literature review.
There are occasional nucleoli and very little mitosis occurs. To date few cases have been described in sites other than these areas 2, 4, 7, Subsequently, abdominal ultrasonography USGcontrast-enhanced abdominal tomography CTand magnetic resonance imaging MRI were performed for estimating the tumor size, invasion degree of the mass, distant metastasis, and also ruling out other intra-abdominal lesions.
Further evidence is required to establish the true value of this treatment. Ann R Coll Surg Engl ; However, it may be detected even after postoperative 15 years [ 11 ]. A small incision in the right perianal angiomjxoma is made to remove the last adhesions and the resected piece 7.
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 snd either an exclusively abdominal or an exclusively perineal approach.
We also suppose the use of antihormonal therapy as an adjuvant therapy for AA to prevent recurrences like in breast cancer. Aggressive angiomyxomas are extremely rare. 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.
First described in by Steeper and Rosai in the soft tissues of the pelvis and perineum of premenopausal women, these tumors appear to be benign in cytology, composed of ltierature and star cells embedded in a myxoid matrix containing medium caliber vessels.
A patient of 2 years old is the youngest reported in the literature to date 2, It is important to differentiate angiomyxoma from angiomyofibroblastoma of the vulva which shares histogenic features with it.
It is most frequently found in the scrotum, perineum, groin, pelvis and spermatic cord 1.