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 of larynx: case report and literature review

“…7 Negativity for S-100 protein is consistent, 6,7 and negativity for muscle-specific antigen variable. 6,8 In our case, the only similarity with the pelvic form was negativity for S-100 protein, as positivity for desmin, cluster of differentiation 34 glycoprotein and smooth muscle actin was not found, suggesting either little immunohistochemical similarity or greater variability in the laryngeal form.…”

“…4,5 Histologically, this neoplasm is characterised by a proliferation of spindle-shaped or stellate cells widely separated by loose, myxoid stroma, in which is dispersed a prominent vascular component. Immunohistochemically, female pelvic aggressive angiomyxomas have been found to be invariably positive for vimentin, desmin, cluster of differentiation 44, 34 and K4 glycoprotein, oestrogen receptors, progesterone receptors, smooth muscle actin, 6 and cytokeratin AE1/AE3. 7 Negativity for S-100 protein is consistent, 6,7 and negativity for muscle-specific antigen variable.…”

Myxomatous neoplasms in the perineal region of baboons

“…It consists of fibroblasts, myofibroblasts and thick‐walled vessels often surrounded by thin streams of smooth muscle separated by an abundant myxoid matrix and may differentiate toward specialized genital stroma [21]. These tumors are immunoreactive for vimentin, smooth muscle actin and desmin with some authors reporting positivity for estrogen and progesterone receptors and general non‐reactivity for S100 protein [1, 11, 14, 25, 33]. Our baboon cases similarly demonstrated 100% estrogen and progesterone reactivity and the majority were Des33 and smooth muscle actin immunoreactive.…”

“…However, author opinions vary on the importance of desmin immunoreactivity. Skalova et al [29] posit that the immunophenotype of aggressive angiomyxoma and angiomyofibroblastoma can be identical and Amezcua et al [1] report that immunohistochemistry is of little help because desmin immunoreactivity is also reported in aggressive angiomyxomas.…”

Myxoid Degeneration of Ovarian Tumor in Young Patient, Laparoscopic Approach

“…Infiltrative surgical margins with invasive structures through surrounding fat tissue filled with a vascular pattern [7].…”