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 likelihood of metastasis of this tumor 3. Adjuvant antihormonal therapy yields promising results for preventing recurrence. AA should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region, particularly in women of reproductive age. Nevertheless, longer-term follow-up using the same studies should be considered 11, 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.
It has been reported in male and female children as young as 2 years old 2, 3, 5. Angiomixoma agresivo en hombres. Until we have more information these chromosomal findings are not uniform in any way, but rather mere curiosities , 10, 11, 14, In the present patient, AA was misdiagnosed as incarcerated femoral hernia and the patient underwent emergent surgery which resulted in surgical failure. Nevertheless, there have been reports of recurrences occurring up to 17 years after initial surgery. The tumor usually arises from the pelvic and perineal regions; however, uncommon localization has been reported in the literature [ 2 , 3 ]. Complete excision of the lesion with wide surgical margins is the treatment of choice.
Until we have more information these chromosomal findings are not uniform in any way, but rather mere curiosities10, 11, 14, Male patients may test positive for estrogen and progesterone receptors However, long-term use of these drugs is still controversial because of their adverse effects.
Mucoid and whirling after cutting. Nevertheless, literaturs their cytologically harmless appearance, they are infiltrating tumors with high risks of recurrence 1, 3, Blood vessels are medium size and large with a variety of secondary changes including medial hypertrophy and fibrointimal proliferation scattered throughout the tumor forming a thick hyalinized wall. A distal rectal examination showed a firm mass attached to the right side of the distal rectum without infiltration.
Case Reports in Surgery
Thus, we emphasize that although it is a rare condition, particularly, a female in reproductive age with a painless swelling located around the genitofemoral region should be well examined by imaging studies to rule out AA and to decide the surgical strategy, as well. Recurrence has been developed mostly within the first 3 years [ 14 ]. For these reasons, most recurrences are related to inadequate resection and the presence of residual tumor 9.
Subscribe to Table of Contents Alerts. Zuur and The Language Workshop Received: Presentation of the presacral tumor after performing digital dissection of retrorectal space.
It reduces high levels of circulating estrogen and prevents conversion of endogenous estrogen and has achieved tumor volume reduction from transverse measurements of 8.
Moreover, long-term treatment with GnRH agonists may induce adverse effects such as osteoporosis and depression even among young women. MRIs are preferable to CAT scans because of their better tissue characterization and lack of ionizing radiation.
Aggressive angiomyxoma: a case series and literature review.
A small incision in the right perianal margin is made to remove the last adhesions and the resected piece 7. During the dissection, no infiltration into the adjacent organs was detected except a partial invasion into the left external iliac vein.
Although its features are benign, two cases with distant metastasis in women for whom aggressive angiomyxkma was fatal have been described. AA is derived from myofibroblasts as a phenotypic variant of the basic fibroblast with a prominent vascular component [ 6 ]. The most common clinical symptom is painless swelling at vulva or groin area. Journal of Clinical Oncology ; However, long-term use of these drugs is associated with side effects such as menopausal symptoms and bone loss.
Archive ouverte HAL – Aggressive angiomyxoma: A case series and literature review
Given their propensity for local recurrence, differential diagnoses should be done literatue multiple benign myxoid lesions, even though clinical, microscopic and immunohistochemical characteristics are shared by several types of tumors.
This is key to determining the choice of surgical approach either perineal, abdominal, or both in order not to leave residual tumor 2, 6, 9. Nevertheless, the wide reported age range csse patients and onset in males theoretically limits the possibility of a hormone dependent cause 3, 4, 7, AA commonly manifests a painless swelling located around the genitofemoral region.
Moreover, the optimal duration of therapy is unknown. On histopathologic examination, the border of the tumor was clear. These cases are very common, and often unexpected.
It is most frequently found in the scrotum, perineum, groin, pelvis and spermatic cord 1. 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. Complete surgical excision with tumor-free margins is still accepted as the main treatment method for AA [ 1 — 9 ].
Int J Gynecol Cancer ; Histopathologic examination of the tumor.