A Case Report of Aggressive Angiomyxoma in Pregnancy: Do Hormones Play a Role?

Abstract

Aggressive angiomyxoma is a rare, locally invasive tumor that generally affects the perineum and pelvis of reproductive age females. Aggressive angiomyxoma is often misdiagnosed, resulting in the delay of the treatment. Case reports show increased growth of the tumor during pregnancy, thus suggesting a hormonal dependency. We report this rare condition in a 29-year-old primigravid female with a growing mass on the right labium majus at 20 weeks' gestation. The patient also developed a smaller mass on the left labium majus at 37 weeks' gestation. The patient underwent a primary cesarean section with resection of the right labial mass, with a final diagnosis of aggressive angiomyxoma. The lesion on her left labium majus resolved spontaneously postpartum. This case report supports a hormonal involvement in this tumor.

A persistent mass: A case of aggressive Angiomyxoma of the vulva

“…AAM has been shown to possess estrogen receptors and progesterone receptors, suggesting growth is hormonally responsive. This is supported by evidence of rapid tumor growth or recurrence during pregnancy ( Orfanelli et al, 2016 ). Recently, medical treatment using hormonal agents, in particular gonadotropin releasing hormone (GNRH) agonists, sometimes in combination with selective estrogen receptor modulators (SERM), has been described in treatment of recurrent tumors ( Palomba et al, 2011 ).…”

Aggressive angiomyxoma in pregnancy: a case report and literature review

“…The first case of AA in pregnancy was reported in 1995, and only 16 cases have been reported in pregnancy to date ( Table 1 ). 2 – 15 The cause of AA is unknown. Our case was similar to most cases of AA in pregnancy.…”

Management of bladder tumors in pregnancy: A case of tumor prolapse and avulsion during labor

“… 4 PR expression is feature of deep angiomyxomas, which are locally invasive and recur in half the cases regardless of size or margins. 5 Although there are case reports describing recurrence of angiomyxomas in the setting of pregnancy, the role of pregnancy-related hormone fluctuations is not clear. 5 In contrast, an inflammatory myofibroblastic tumor may be slow growing with little risk of metastasis, and a fibroepithelial polyp would be unlikely to recur.…”