Aggressive angiomyxoma of the female genital tract: a clinicopathologic and immunohistochemical study of 12 cases

Abstract

Aggressive angiomyxoma (AAM) is a distinctive neoplasm seen in the female genital tract. We present the clinicopathological findings of 12 female patients with AAM. Immunohistochemical analysis for vimentin, desmin, smooth-muscle actin (SMA), muscle-specific actin (MSA), S-100, CD44, estrogen receptor (ER), and progesterone receptor (PR) was performed. Mean patient age was 39 years (range 20-77 years). Eight tumors arose in the vulva, two in the suburethral area, and two in the perirectal area. Three were pedunculated (two vulvar and one suburethral). Perineal tumors were locally excised, with limited removal of adjacent tissue or tissue surrounding the pedicle base of pedunculated tumors. Perirectal tumors were removed by wide excision. Tumors ranged 2.8-40.0 cm in size. Eleven patients were followed-up (mean 19 months). Recurrence occurred in one patient 48 months after tumor resection from perirectum and abdomen. Immunohistochemistry showed tumor positivity for vimentin (11/11), desmin (8/11), CD44 (8/11), ER (10/12), PR (11/12), and SMA (3/11). MSA and S-100 were negative. In summary, AAM in the perineum especially pedunculated tumors may possibly require only local excision for definitive treatment. Furthermore, the majority of AAM have CD44 expression.

Aggressive Angiomyxoma

“…Aggressive angiomyxoma occurs predominantly in women of reproductive age, with a peak incidence in the fourth decade of life and an age range of 11 to 77 years. [3][4][5] In men, AAM involves analogous sites, including the inguinoscrotal region and the perineum. 6 At initial clinical evaluation, AAM is often mistaken for more-common, superficial lesions, such as vaginal or labial cysts and lipomas, and the frequently large, bulky size and extent of the deep tissue involvement is not appreciated until radiographic imaging and surgical resection are performed.…”

Aggressive angiomixoma during pregnancy (a case report)

“…Анализ лите-ратуры [9] подтверждает, что агрессивная ангиомик-сома является стероидзависимой. Кроме прогесте-роновых рецепторов, в ней часто находят эстрогено-вые [8,10]. В связи с этим некоторые авторы [11] предполагают возможность гормональной терапии этого заболевания.…”

Angiomyofibroblastoma of the vulva: A case report with literature review

“…In contrast, AAM is borderline and locally aggressive tumor. AAM is highly recurrent especially with improper resection so more aggressive surgery is needed [4]. The things that make treatment of AAM difficult are large size of the mass, infiltration to pelvic nerves or vessels, and recurrence even after complete resection [5].…”