|
1
|
Aquino CI, Tinelli R, Libretti A, Bertinato R, Boldorini RL, Giana M, Sorrentino F, Nappi L, Remorgida V, Surico D. Aggressive Pelvic Angiomyxoma in a Patient with Twin Pregnancy: Diagnosis, Treatment, and Clinical Complications in Light of the Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1417. [PMID: 37629707 PMCID: PMC10456254 DOI: 10.3390/medicina59081417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 08/27/2023]
Abstract
(1) Background: Aggressive angiomyxoma is a mesenchymal cancer that is rare during pregnancy. It is a neoplasm that relapses and infiltrates the nearest structures. Our aim is to evaluate the management and outcomes of an observed case, in light of the current literature. (2) Methods: We observed this condition at the "Maggiore della Carità" Hospital in Novara (Italy) in a patient with an initial twin pregnancy and a suspected pelvic mass. The words "angiomyxoma" and "pregnancy" were searched on the main online scientific search sources (PubMed, Google Scholar, Scopus, WES, and Embase, etc.). (3) Results: The patient underwent surgery with a complicated follow-up, but recent negative controls. We analyzed the literature about the topic and found only 24 similar clinical cases. (4) Conclusions: Considering the current literature, it is useful to assess an aggressive angiomyxoma in the differential diagnosis of soft masses in pregnant women. The treatment of choice is surgical excision, and vaginal delivery is feasible. The therapeutic decision depends on each case.
Collapse
Affiliation(s)
- Carmen Imma Aquino
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| | - Raffaele Tinelli
- Department of Obstetrics and Gynecology, “Valle D’Itria” Hospital, Martina Franca, 74015 Taranto, Italy
| | - Alessandro Libretti
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
| | - Riccardo Bertinato
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
| | - Renzo Luciano Boldorini
- Department of Pathology, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy;
| | - Michele Giana
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
| | - Felice Sorrentino
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy; (F.S.); (L.N.)
| | - Luigi Nappi
- Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, 71121 Foggia, Italy; (F.S.); (L.N.)
| | - Valentino Remorgida
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| | - Daniela Surico
- Department of Gynecology and Obstetrics, “Maggiore della Carità” Hospital, University of Piemonte Orientale, 28100 Novara, Italy; (C.I.A.); (A.L.); (R.B.); (M.G.); (V.R.); (D.S.)
- Department of Translational Medicine, University of Piemonte Orientale, 28100 Novara, Italy
| |
Collapse
|
|
2
|
Cicogna S, Dellino M, Miano ST, Magazzino F, Domenici L, Pignata S, Mangili G, Cormio G. Aggressive Angiomyxoma of the Lower Female Genital Tract in Pregnancy: A Review of the MITO Rare Tumors Group. Cancers (Basel) 2023; 15:3403. [PMID: 37444513 DOI: 10.3390/cancers15133403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/23/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Deep (aggressive) angiomyxoma of the lower genital tract is a rare malignancy affecting women of reproductive age. Being a hormone-sensitive tumor, its growth is particularly benefitted during pregnancy. Surgical excision with complete resection is indicated, even if a wait-and-see approach can be considered until delivery, to avoid destructive surgeries. The mode of delivery is to be evaluated based on the location and size of the neoplasm; vaginal delivery is not contraindicated, as long as the tumor does not obstruct the birth canal. Positive surgical margins are the most important prognostic factor for recurrence. Adjuvant therapy with gonadotropin-releasing hormone analogues may be proposed after pregnancy, in the case of non-radical surgery. Despite the high local relapse rate, the outcomes for mother and child are favorable. Since recurrences can occur after many years, the patient should be included in long-term follow-up.
Collapse
Affiliation(s)
- Stefania Cicogna
- Institute for Maternal and Child Health-IRCCS "Burlo Garofolo", 34145 Trieste, Italy
| | - Miriam Dellino
- Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Salvatora Tindara Miano
- Complex Operating Unit of Oncology, Azienda Ospedaliera Universitaria Senese, 53100 Siena, Italy
| | - Francescapaola Magazzino
- Complex Operating Unit Ginecologia E Ostetricia, Ospedale Civile Di San Dona' Di Piave (Venezia), Aulss4 Veneto Orientale, 30027 San Donà di Piave, Italy
| | - Lavinia Domenici
- Division of Obstetrics and Gynecology, Azienda Ospedaliera Universitaria Pisana, University of Pisa, 56126 Pisa, Italy
| | - Sandro Pignata
- Department of Urology and Gynecology, Istituto Nazionale Tumori IRCCS 'Fondazione G Pascale', 80144 Napoli, Italy
| | - Giorgia Mangili
- Obstetrics and Gynecology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
| | - Gennaro Cormio
- Department of Interdisciplinary Medicine (DIM), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, 70124 Bari, Italy
- Gynecologic Oncology, IRCCS Istituto Tumori "Giovanni Paolo II", 7012 Bari, Italy
| |
Collapse
|
|
3
|
Xu H, Sun P, Xu R, Wang L, Shi Y. Aggressive angiomyxoma in pregnancy: a case report and literature review. J Int Med Res 2021; 48:300060520936414. [PMID: 32644864 PMCID: PMC7350053 DOI: 10.1177/0300060520936414] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Aggressive angiomyxoma is an interstitial tumour that is often misdiagnosed and is likely to recur. There have been few reported cases of angiomyxoma in pregnant women. We report a case of a woman who was previously diagnosed with a tumour in her vulva that increased in size during both of her pregnancies and spontaneously decreased postpartum. Local excision was performed and a gonadotropin-releasing hormone agonist was administered. According to a literature review, aggressive angiomyxoma is associated with good maternal and child outcomes. Caesarean section is not the delivery method of choice, but it is indicated if the tumour is preventing vaginal birth. Treatment for angiomyxoma is mainly postpartum local resection supplemented by hormone therapy. This tumour frequently recurs and patients should undergo long-term follow-up.
Collapse
Affiliation(s)
- Haihua Xu
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Pengming Sun
- Laboratory of Gynecology Oncology, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Pengming Sun, Laboratory of Gynecologic Oncology, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, No. 18 Daoshan Road, 350001 Fuzhou, Fujian, China.
| | - Rongli Xu
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Lihua Wang
- Department of Obstetrics, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yuequan Shi
- Department of Imaging, Fujian Maternal and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
| |
Collapse
|