Aggressive angiomyxoma of the ischioanal fossa in a post-menopausal woman

Abstract

Aggressive angiomyxoma is a rare mesenchymal tumour, primarily arising in the soft tissue of the pelvis and perineum in women of reproductive age. There is a paucity of evidence on optimal management because of the rarity of these tumours, but the consensus has been for surgical excision. We present the case of a 65-year-old woman who was admitted with left-sided buttock pain and initially diagnosed with a perianal abscess. She underwent examination under anaesthesia rectum with surgical excision of the lesion, subsequent histopathological and immunochemical analysis was suggestive of aggressive angiomyxoma. To complement our case report, we also present a literature review focusing on aggressive angiomyxoma in the ischioanal fossa (also known as the ischiorectal fossa) with only eight cases of primary aggressive angiomyxoma involving the ischioanal fossa documented to date. The primary aims of this case report and literature review are to familiarise clinicians with the clinical, histopathological and immunochemical features of these tumours, and to increase appreciation that despite the rarity of aggressive angiomyxoma, it might be considered in the differential diagnosis of ischioanal lesions.

Aggressive angiomyxoma: The first case report in skull

“…Microscopically, the tumor consists of bland spindle cells, loosely arranged in a myxoid edematous stroma, with vascular proliferation of various sizes ( 20 ). In the histological analysis of the present case, short spindle cells were seen on a mucous background with mild, aggressive growth of the cells, combined with previous cases of perineal AAM that demonstrated a spindle cell neoplasm with numerous blood vessels in a myxoid background, highly suggestive of AAM ( 21 – 23 ). At the same time, we also need to conduct immunohistochemical analysis.…”

Characteristics and treatment strategies of aggressive angiomyxoma in women: A retrospective review of 87 cases

“…A total of 74 articles were included (4-77), containing 87 cases. Among the 74 studies, 37 were in Chinese (4-6, 8-12, 14, 15, 17, 19, 21, 22, 25-31, 33-35, 39, 40, 43, 45, 46, 51-53, 55, 56, 60, 61, 77), 34 were in English (7,13,16,18,20,23,24,32,36,38,41,42,44,47,50,54,(57)(58)(59)(62)(63)(64)(65)(66)(67)(68)(69)(70)(71)(72)(73)(74)(75)(76), and three were in Spanish (48,49,54). Most patients came from Asia (77.0%), especially China (60.1%), a few from Europe (13.8%) and North America (7.0%), and only very few were from Africa (1.1%) and South America (1.1%) (Supplementary Table ).…”

Aggressive angiomyxoma of the pelvis and vagina: a robotic and vaginal combined approach

“…Aggressive angiomyxoma is a rare mesenchymal tumor, typically arising in the soft tissue of the pelvis and perineum,1 with local aggressive behavior and frequent local recurrence. Surgical excision is the standard treatment, and it is especially relevant to acquire negative pathologic margins to reduce the local relapse 2…”