Aggressive angiomyxoma of the vulva: case report

Abstract

Female patient, 42-years-old, complaining of difficulty in urinating and swelling in the vulvar area for one year. Her gynecological examination showed extensive injury in the vulvar region and the biopsy done was inconclusive. The removal of the lesion was conducted. After the procedure, the patient remains free of recurrence for 15 months. This case highlights the need to consider angiomyxoma in the differential diagnosis for tumors of unknown cause in the vulvar region.

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“…This case highlights the need to consider angiomyxoma in the differential diagnosis for tumors of unknown cause in the vulvar region [7]. Even though it is a rare diagnosis, it must be identified in order to properly treat it and prevent invasion of local structures.…”

“…It can sometimes occur in men but the female to male ratio is 6.6:1 [2]. The tumor usually occurs in either the perineal or pelvic region and typically presents as a slow growing, painless mass [7,15]. AA is considered to be an aggressive tumor because it has a high risk of infiltration and local recurrence [16].…”

“…Histopathologic exam is the gold standard of diagnosis of AA. It typically reveals vessels of medium size surrounded by a layer of stromal cells of myxoid appearance and is usually hypocellular to moderately cellular [1,7]. Histologic evaluation of the neoplastic cells also reveals bland stellate and spindle cells with pale eosinophilic cytoplasm and thin cytoplasmic processes and either round or ovoid nuclei [1].…”

“…The pathogenesis of AA is still unclear. However, a translocationof chromosome 12 has been implicated as a possible cause [7,28,29]. This translocation results in an aberrant expression of the high mobility group protein isoform I-C (HMGI-C) protein that is involved in DNA transcription [30,31].…”

Vulvar Tumor - Case Report and Literature Review

“…It is more often diagnosed in women, who have worse prognosis due to the possibility of having the tumor invading the pelvis and the perineum, a fact that can lead to a series of severe complications such as compression of pelvic organs. Therefore, complementary pelvic and abdominal evaluation was performed; results came out normal [9,10].…”