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Narang M, Das P, Singh AN, Madhusudhan KS. Aggressive angiomyxoma of the stomach: a novel site of a rare neoplasm. BMJ Case Rep 2022; 15:e249182. [PMID: 35793846 PMCID: PMC9260789 DOI: 10.1136/bcr-2022-249182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/04/2022] Open
Abstract
Aggressive angiomyxoma (AA) is a rare neoplasm of mesenchymal origin. It most commonly occurs in young women, predominantly in the pelvi-perineal region. We describe a case of AA arising from the lesser curvature of the stomach in a young woman who presented with a lump in the abdomen for 6 months. The patient subsequently underwent en bloc resection of the tumour and the diagnosis was confirmed on histology. This is the first reported case of gastric origin of AA to the best of our knowledge.
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Affiliation(s)
- Mohak Narang
- Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Prasenjit Das
- Pathology, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Anand Narayan Singh
- Gastrointestinal Surgery, All India Institute of Medical Sciences, New Delhi, Delhi, India
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2
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Ayati E, Pesikhani MD, Karamali M, Borhan A, Pourali L. A deep giant aggressive angiomyxoma of the labia majora: A case report. Int J Surg Case Rep 2022; 96:107313. [PMID: 35716621 PMCID: PMC9213251 DOI: 10.1016/j.ijscr.2022.107313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/10/2022] [Accepted: 06/12/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Aggressive Angiomyxoma (AA) is an uncommon, locally infiltrative mesenchymal tumor that primarily originates from perineal and pelvic sites of women, particularly in the 4th decade of life with having an emphasized tendency for local recurrence, whereas it has a low tendency to metastasize. Patients often present with nonspecific symptoms such as painless visible mass that might be misdiagnosed with every mass in genital and pelvic sites in reproductive-age women. CASE PRESENTATION We describe a 31-year-old female presenting with an enlargement on the right labia majora. Ultrasound and magnetic resonance were carried out, and the mass was surgically excised completely and without complication. The diagnosis of AA was made based on characteristic histopathological features. The postoperative follow-up for recurrence is currently being continued. CLINICAL DISCUSSION Due to its rarity and lack of specificity in clinical and radiological examinations, the pre-operative misdiagnosis rate of AA is rather high. Hence, most cases are diagnosed on histology after initial surgical excision. Surgical management is the gold standard treatment for primary tumors; however, in case of local recurrences, treatment choices range from surgical resection to gonadotropin-releasing hormone (GnRH) agonist for tumors positive for estrogen and progesterone receptors. CONCLUSION Wide surgical resection is the gold standard treatment of AA; however, exceptions might occur due to the depth of tumor infiltration to adjacent viscera. Therefore, adjunct medical therapies can play a crucial role in treatment. In addition, long-term follow-up is necessary due to the high rate of local recurrences.
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Affiliation(s)
- Elnaz Ayati
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author at: Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Imam Khomeini Hospital Complex, Tehran 1419733141, Iran.
| | - Maryam Deldar Pesikhani
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Karamali
- Department of Obstetrics and Gynecology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Armin Borhan
- Department of Pathology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Pourali
- Department of Obstetrics and Gynecology, Mashhad University of Medical Sciences, Mashhad, Iran
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3
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Dhamija E, Aswar H, Ehmad S, Barwad A, Pandey R, Rastogi S. Radio-pathological and Clinical Correlation of Aggressive Angiomyxoma: Experience of a Tertiary Care Cancer Hospital. Indian J Radiol Imaging 2021; 31:566-572. [PMID: 34790299 PMCID: PMC8590556 DOI: 10.1055/s-0041-1735913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor predominantly affecting the pelvis and perineum of females. Due to its variable clinical presentation, it is often misinterpreted and treated as other pathologies like Bartholin gland cyst, vulvar abscess, and hernia. The tumor is locally infiltrative, making its complete surgical removal difficult. Aim The aim of the study is to highlight and illustrate the imaging and pathological features of AAM. Materials and Methods After obtaining clearance from the Institutional Ethics Committee, a retrospective study was conducted on patients with histopathological diagnosis of AAM, presenting to the dedicated sarcoma clinic between 2016 and 2019. The demographic, clinical, radiological, pathological, and treatment details were obtained from the institute's database. The magnetic resonance imaging (MRI) and computed tomography images were reviewed to assess different imaging parameters. Follow-up imaging was assessed for residual or recurrent mass in the pelvis or perineum and distant metastasis. Results A total of four patients were included with an age range of 28 to 50 years. The baseline MRI of these four patients shows pelvic mass extending into the perineum, infiltrating along the surrounding fascial planes with the characteristic laminated appearance on T2-weighted image and gradual intense enhancement following contrast administration. All patients had residual disease post-surgery and were put on hormonal therapy. Conclusion AAMs are locally aggressive, rarely metastasizing mesenchymal tumor that has a specific predilection for the perineum and pelvis of females. MRI features like laminated or striated appearance, post-contrast enhancement, and finger-like infiltrating projections should raise the suspicion of the diagnosis on baseline imaging.
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Affiliation(s)
- Ekta Dhamija
- Departments of Radiodiagnosis, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Harshal Aswar
- Departments of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sawyer Ehmad
- Departments of Radiodiagnosis, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Adarsh Barwad
- Departments of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Rambha Pandey
- Departments of Radiation Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sameer Rastogi
- Departments of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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4
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Altinmakas E, Dogan H, Temur M, Guneyli S. Incidentally detected perineal aggressive angiomyxoma in an asymptomatic patient with uterine leiomyomas. J OBSTET GYNAECOL 2021; 41:1178-1179. [PMID: 33632039 DOI: 10.1080/01443615.2020.1849070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Emre Altinmakas
- Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Hakan Dogan
- Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
| | - Muzaffer Temur
- Department of Obstetrics and Gynecology, Private Doruk Hospital, Bursa, Turkey
| | - Serkan Guneyli
- Department of Radiology, Koc University School of Medicine, Istanbul, Turkey
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5
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Alosaimi AM, Al-Jifree HM, Alharbi SY, Algethami AS. Aggressive Angiomyxoma of the Posterior Wall of the Uterus. Cureus 2020; 12:e12023. [PMID: 33329983 PMCID: PMC7734890 DOI: 10.7759/cureus.12023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Aggressive angiomyxoma (AA) is a rare benign mesenchymal tumor that usually arises in the vulvovaginal and perineal regions of premenopausal females. The treatment of choice is surgical excision. Hormonal therapy or radiotherapy have emerged as alternative forms of treatment but are indefinite. In this article, we report a case of aggressive angiomyxoma in the posterior wall of the uterus of a 35-year-old Saudi female patient. The clinical data, imaging, histopathology, treatment, and prognosis were analyzed, and related literatures were reviewed. The frequency of recurrence in these tumors emphasizes the importance of long-term follow-ups.
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Affiliation(s)
- Amal M Alosaimi
- Department of Oncology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Department of Oncology, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Hatim M Al-Jifree
- Department of Gynecologic Oncology, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Department of Oncology, King Abdullah International Medical Research Center, Jeddah, SAU.,Department of Oncology, Ministry of National Guard Health Affairs, Jeddah, SAU
| | - Suzan Y Alharbi
- Department of Oncology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Department of Oncology, King Abdullah International Medical Research Center, Jeddah, SAU
| | - Amirah S Algethami
- Department of Oncology, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU.,Department of Oncology, King Abdullah International Medical Research Center, Jeddah, SAU
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6
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Abduljabbar A, Wazzan M. Recurrent aggressive angiomyxoma presented with perianal mass and typical imaging swirl sign. Int J Surg Case Rep 2020; 72:486-489. [PMID: 32698271 PMCID: PMC7322231 DOI: 10.1016/j.ijscr.2020.06.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/23/2020] [Accepted: 06/03/2020] [Indexed: 11/18/2022] Open
Abstract
Silent growing pelvic mass in middle age women with tendency to insinuate within the pelvis is commonly seen in aggressive angiomyxoma. The presence of swirl sign with the mass and striated appearance in T1 weighted and T2 weighted images are commonly seen with this tumour. Surgical intervention, radiotherapy, hormonal therapy and chemotherapy are valid treatment options.
Introduction Aggressive angiomyxoma is a rare pelvic neoplasm that arises commonly in middle aged women and usually has delayed presentation due to its typically silent and slow growing behavior. Clinical presentation A 47-year-old woman presented at our hospital with recurrent attacks of pelvic pain and a perianal bulge. Her past medical history was relevant due to previous en bloc resection of a right ovarian angiomyxoma. Current cross sectional imaging, including computed tomography and magnetic resonance imaging, was performed and showed evidence of local recurrence. Various available treatment options were offered to the patient. Discussion The imaging features of the aggressive angiomyxoma were peculiar and showed a swirl and lamellate appearance in T1 and T2 weighted images. Conclusion A locally aggressive tumor with benign histopathology and swirl sign in imaging is highly suggestive of aggressive angiomyxoma.
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Affiliation(s)
- Ahmed Abduljabbar
- King Abdul Aziz University, Radiology Department, Faculty of Medicine, P.O. Box 80215. Jeddah, 21589, Jeddah, Saudi Arabia.
| | - Mohammad Wazzan
- King Abdul Aziz University, Radiology Department, Faculty of Medicine, P.O. Box 80215. Jeddah, 21589, Jeddah, Saudi Arabia
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7
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Lin C, Huang F, Li F, Zhu X, Jiang X, Tie L, Shen G, Cheng J. Clinicopathologic and treatment features of aggressive angiomyxoma: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2019; 12:1816-1819. [PMID: 31934004 PMCID: PMC6947119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 03/25/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The present study is to accumulate clinicopathologic and treatment data on aggressive angiomyxoma (AA), a rare tumor. METHODS Various clinical findings were analyzed in 9 patients with AA at Affiliated Tumor Hospital of Xinjiang Medical University from 1996 to 2016. RESULTS Nine patients (8 females and 1 male) were included in the present study, with an age range from 14 to 63 years (median age, 33.4 years). The sites of tumor in 6 cases were perineum and vagina, right breast, left pelvic peritoneum and right groin (male). Gross examination showed that the tumor was solid and soft, with unclear boundary but no capsule. The cut surface was gray and jelly-like. According to microscopic examination, the tumor had invasive growth, and small fusiform or star-shaped cells being dispersed in a myxoid background, enclosing several capillary structures with a thin wall. The initial treatment was localized excision. Follow-up showed that 2 patients died from cardiovascular and cerebrovascular disease, 2 patients had local recurrence, 2 patients were withdrawn, and others had neither local recurrence nor distant metastasis. Follow-up time was 3-25 years. CONCLUSION AA is a rare tumor that occurs predominantly in females. Local resection is appropriate to manipulate the tumor, and local recurrence is common.
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Affiliation(s)
- Chen Lin
- Department of Pathology, Basic Medical Sciences, Xinjiang Medical UniversityNo. 393 Xinyi Road, Urumqi 830011, China
| | - Fei Huang
- Department of Pathology, The Affiliated Tumor Hospital of Xinjiang Medical UniversityNo. 789 Suzhoudong Road, Urumqi 830000, China
| | - Fen Li
- The Third Department of Gynecology, The Affiliated Tumor Hospital of Xinjiang Medical UniversityNo. 789 Suzhoudong Road, Urumqi 830000, China
| | - Xiaonan Zhu
- The Third Department of Gynecology, The Affiliated Tumor Hospital of Xinjiang Medical UniversityNo. 789 Suzhoudong Road, Urumqi 830000, China
| | - Xiaojuan Jiang
- The Third Department of Gynecology, The Affiliated Tumor Hospital of Xinjiang Medical UniversityNo. 789 Suzhoudong Road, Urumqi 830000, China
| | - Liping Tie
- The Third Department of Gynecology, The Affiliated Tumor Hospital of Xinjiang Medical UniversityNo. 789 Suzhoudong Road, Urumqi 830000, China
| | - Guqun Shen
- The Third Department of Gynecology, The Affiliated Tumor Hospital of Xinjiang Medical UniversityNo. 789 Suzhoudong Road, Urumqi 830000, China
| | - Jingxin Cheng
- Department of Obstetrics and Gynecology, Shanghai East Hospital Affiliated to Tongji UniversityNo. 150 Jimo Road, Shanghai 200120, China
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Raptin C, Lucot JP, Bassil A, Poncelet E, Prolongeau JF, Phalippou J. Aggressive angiomyxoma of the perineal region. SAGE Open Med Case Rep 2019; 7:2050313X19843391. [PMID: 31019700 PMCID: PMC6463328 DOI: 10.1177/2050313x19843391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 03/18/2019] [Indexed: 11/15/2022] Open
Abstract
Aggressive angiomyxoma is a rare tumour that frequently involves the perineal region with a high risk of local recurrence. This is a case report of a 24-year-old female patient with a genital prolapse. We performed a surgical treatment. Histological examination found an aggressive angiomyxoma. The tumour recurred 1 year after surgery. Long-term follow-up is necessary.
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Affiliation(s)
- Clémence Raptin
- Département Obstétrique et Gynécologie, Maternité Monaco, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Jean-Philippe Lucot
- Service de Gynécologie-Obstétrique, Hôpital Saint Vincent de Paul, Lille, France
| | - Alfred Bassil
- Département de cancérologie gynécologique, Centre Oscart Lambret, Lille, France
| | - Edouard Poncelet
- Service de Radiologie et Imagerie de la Femme, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Jean-François Prolongeau
- Département Obstétrique et Gynécologie, Maternité Monaco, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Jéröme Phalippou
- Clinique de Gynécologie, Hôpital Jeanne-de-Flandre, Centre Hospitalier Régional Universitaire de Lille, Lille, France
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9
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Zhao CY, Su N, Jiang YX, Yang M. Application of ultrasound in aggressive angiomyxoma: Eight case reports and review of literature. World J Clin Cases 2018; 6:811-819. [PMID: 30510948 PMCID: PMC6264985 DOI: 10.12998/wjcc.v6.i14.811] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/16/2018] [Accepted: 10/22/2018] [Indexed: 02/05/2023] Open
Abstract
Aggressive angiomyxoma (AAM) is a rare tumour that often occurs in soft tissues of the female genital tract. Eight cases of AAM are reported in this article, and the clinical features and ultrasound and magnetic resonance imaging (MRI) results of the eight cases are reviewed and summarized. The main complaints of all the patients were palpable and painless masses in the vulva or scrotum. The lesions were mainly located in the vulva, pelvis, and perineal region, with a large scope of involvement. The sonographic features of AAM were characteristic. On sonography, all of the masses were of irregular shape and showed hypoechogenicity, with a heterogeneous inner echotexture. Intratumoural and peritumoural blood flows were detected by colour Doppler imaging. On real-time ultrasonic imaging, prominent deformation of the lesions was observed by compressing the masses with the probe. Some special imaging features were also revealed, including a laminated or swirled appearance of inner echogenicity, and a finger-like or tongue-like growth pattern. On MRI imaging, the lesions showed intermediate-intensity signals and intermediate to high-intensity signals on TI-weighted and T2-weighted sequences. A rapid and uneven enhancement pattern was demonstrated. After the comparison of sonographic features with MRI and pathological findings, we found the relevance of the ultrasonographic characteristics with MRI and histological features of AAM. Ultrasound can be a valuable imaging method for the preoperative diagnosis, evaluation of scope, and follow-up of AAM.
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Affiliation(s)
- Chen-Yang Zhao
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
| | - Na Su
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
| | - Yu-Xin Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
| | - Meng Yang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
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10
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Sun Y, Zhu L, Chang X, Chen J, Lang J. Clinicopathological Features and Treatment Analysis of Rare Aggressive Angiomyxoma of the Female Pelvis and Perineum - a Retrospective Study. Pathol Oncol Res 2016; 23:131-137. [PMID: 27571990 DOI: 10.1007/s12253-016-0109-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 08/24/2016] [Indexed: 02/07/2023]
Abstract
The study was to evaluate the clinicopathological features of aggressive angiomyxoma (AAM) of the female pelvis and perineum and its treatments. This was a retrospective study of female patients with AAM admitted to our hospital. Clinical and pathological data were analyzed, as well as the postsurgical follow-up. Median age at initial presentation was 41 years. Thirteen patients had lesions involving adjacent organs. Eighteen patients underwent complete tumor resection, while one patient underwent partial tumor resection. The tumors were soft in texture, pink in color, and had mucus on the surface. A microscopic examination revealed that the tumors were non-encapsulated, with spindle cells and stellate cells of almost identical size loosely distributed in the myxoid stroma, and vessels of different sizes and wall thicknesses. Immunohistochemistry indicated that AAMs were strongly positive for CD34 and smooth muscle actin, moderately positive for desmin, estrogen receptors and progesterone receptor, and mostly negative for S-100. After a median follow-up of 24 months, the recurrence rate was 33.3 %. Four recurrences were in patients with positive initial margins. AAM is a slow growing, locally invasive, benign tumor. Complete resection could lead to lower recurrence rate compared with incomplete resection. Follow-up is necessary for recurrent cases with repeated surgeries. The overall prognosis could be favorable.
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Affiliation(s)
- Yin Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100000, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100000, China.
| | - Xiaoyan Chang
- Department of Pathology, Peking Union Medical College Hospital, Beijing, 100000, China
| | - Jie Chen
- Department of Pathology, Peking Union Medical College Hospital, Beijing, 100000, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing, 100000, China
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11
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Aggressive Angiomyxoma: Imaging Findings in 3 Cases With Clinicopathological Correlation and Review of the Literature. J Comput Assist Tomogr 2016; 39:914-21. [PMID: 26529675 DOI: 10.1097/rct.0000000000000305] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Aggressive angiomyxoma is a rare mesenchymal tumor with a typical presentation as a slowly growing perineal soft tissue mass in paravulvar and pararectal region in young adult women. We present 3 cases of aggressive angiomyxoma with clinicopathological correlation and describe their main imaging features with emphasis on magnetic resonance imaging, adding useful information about their behavior on dynamic contrast-enhanced sequences and diffusion-weighted imaging and including a comprehensive review of the existing literature.
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12
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Argiró R, Sacconi B, Iannarelli A, Collini P, Bezzi M. Perineal and pelvic aggressive angiomyxoma: spontaneous regression after hormonal replacement therapy withdrawal assessed by 3T magnetic resonance. BJR Case Rep 2015; 1:20150110. [PMID: 30363609 PMCID: PMC6180818 DOI: 10.1259/bjrcr.20150110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 06/10/2015] [Accepted: 06/16/2015] [Indexed: 11/15/2022] Open
Abstract
Aggressive angiomyxoma (AA) is a rare mesenchymal tumour which mainly arises in the soft tissue of the pelvis and perineum in women of reproductive age. AA usually shows an aggressive behaviour, with a high rate of incomplete surgical excision and post-surgical recurrence. Most cases of AA exhibit oestrogen and/or progesterone receptors; in these cases, maintenance of a hypo-oestrogenic state can be helpful in the medical management of this tumour. We describe a case of spontaneous reduction in size of an AA during a 6-month period of hormonal replacement therapy withdrawal, assessed by MRI using a 3T magnet.
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Affiliation(s)
- R Argiró
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology-Sapienza, University of Rome, Italy
| | - B Sacconi
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology-Sapienza, University of Rome, Italy
| | - A Iannarelli
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology-Sapienza, University of Rome, Italy
| | - P Collini
- Department of Pathology, Istituto Nazionale dei Tumori, Milano Italy
| | - M Bezzi
- Department of Radiological, Oncological and Anatomopathological Sciences-Radiology-Sapienza, University of Rome, Italy
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Myxoid soft-tissue neoplasms: comprehensive update of the taxonomy and MRI features. AJR Am J Roentgenol 2015; 204:374-85. [PMID: 25615761 DOI: 10.2214/ajr.14.12888] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE. The purpose of this article is to review the classification, clinical presentation, and histopathologic and MRI features of myxoid soft-tissue neoplasms. CONCLUSION. MRI is the modality of choice for characterization of myxoid soft-tissue tumors. A combination of imaging features (including certain characteristic signs), clinical features, and patient demographics can help the radiologist in coming to a specific diagnosis or in narrowing down the differential diagnoses.
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Giraudmaillet T, Mokrane FZ, Delchier-Bellec MC, Motton S, Cron C, Rousseau H. Aggressive angiomyxoma of the pelvis with inferior vena cava involvement: MR imaging features. Diagn Interv Imaging 2014; 96:111-4. [PMID: 25533499 DOI: 10.1016/j.diii.2014.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- T Giraudmaillet
- Department of radio-diagnostics and medical imaging, Rangueil Hospital, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse, France.
| | - F Z Mokrane
- Department of general radiology, Rangueil Hospital, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse, France
| | - M C Delchier-Bellec
- Department of general radiology, Rangueil Hospital, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse, France
| | - S Motton
- Department of general surgery and gynecology, Rangueil Hospital, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse, France
| | - C Cron
- Department of cardiovascular surgery, Rangueil Hospital, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse, France
| | - H Rousseau
- Department of general radiology, Rangueil Hospital, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse, France
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15
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Aggressive angiomyxomas: a comprehensive imaging review with clinical and histopathologic correlation. AJR Am J Roentgenol 2014; 202:1171-8. [PMID: 24848813 DOI: 10.2214/ajr.13.11668] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Aggressive angiomyxomas are rare infiltrative mesenchymal neoplasms that commonly recur locally. The purpose of this study was to conduct a retrospective review of imaging findings of aggressive angiomyxomas with clinicopathologic correlation in 16 patients. MATERIALS AND METHODS CT and MRI studies and clinical data of 16 patients with histopathologic evidence of aggressive angiomyxoma who had been referred to our institutions from January 2002 through January 2012 were retrospectively reviewed. The tumors were evaluated with respect to location, morphology, attenuation or signal intensity, and enhancement characteristics. RESULTS The most common location was the pelvis and perineum with the mass on either side of the pelvic diaphragm (12/16, 75%). The characteristic "laminated" appearance was seen in 10 of 12 patients on MRI. Aggressive angiomyxomas showed only mild diffusion restriction and mild (18)F-FDG avidity in both of the two patients who underwent DWI and PET/CT, in keeping with histologic low-mitotic activity. Imaging features, such as collateral vessels and fingerlike growth pattern, were seen in seven of 16 (44%) aggressive angiomyxomas. Internal cystic degeneration was seen in three of 16 (19%) aggressive angiomyxomas. CONCLUSION The finding of a large multicompartmental tumor with a characteristic internal laminated morphology or extension on either side of the pelvic diaphragm should alert the radiologist to the possible diagnosis of aggressive angiomyxoma. Imaging features, such as large peripheral vessels and cystic degeneration are less common, but presence of these features in the background of laminated morphology should not deter the radiologist from suggesting a diagnosis of aggressive angiomyxoma.
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Brennan C, Kajal D, Khalili K, Ghai S. Solid malignant retroperitoneal masses-a pictorial review. Insights Imaging 2013; 5:53-65. [PMID: 24293303 PMCID: PMC3948907 DOI: 10.1007/s13244-013-0294-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/31/2013] [Accepted: 10/11/2013] [Indexed: 12/25/2022] Open
Abstract
Primary retroperitoneal masses are a rare but important group of neoplasms. Cross-sectional imaging has revolutionised the investigation of patients with retroperitoneal neoplasms. Both computed tomography (CT) and magnetic resonance imaging (MRI) can contribute to tumour diagnosis, though histological confirmation is often required because of the considerable overlap of imaging features. Cross-sectional imaging is key to the pre-operative staging and planning of retroperitoneal masses, though ultrasound may also help in certain instances. Imaging also helps to select and guide the site to biopsy from these usually large and heterogeneous neoplasms. This article aims to review many of the primary retroperitoneal neoplasms that may be encountered by the radiologist.
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Affiliation(s)
- Cressida Brennan
- Division of Abdominal Imaging, Joint Department of Medical Imaging, University Health Network - Mount Sinai Hospital - Women's College Hospital, University of Toronto, Toronto, ON, Canada
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