Background/Aim: Aggressive angiomyxomas are mostly found in the pelvic and perineal region and are prone to recur after surgery. Cytogenetic information is available on only nine such tumors. Herein, we report the cytogenetic anomaly and its molecular consequence in another aggressive angiomyxoma. Materials and Methods: An aggressive angiomyxoma found in a 33-year-old woman was examined using cytogenetic, RNA sequencing, reverse transcription polymerase chain reaction (RT-PCR), and Sanger sequencing techniques. Results: The karyotype of short-term cultured tumor cells was 46,XX,del(12) (q14q23)[9]/46,XX [2]. RNA sequencing detected fusion of the high mobility group AT-hook 2 gene (HMGA2) with the chromosome 12 open reading frame 42 gene (C12orf42). RT-PCR together with Sanger sequencing verified the presence of an HMGA2::C12orf42 fusion transcript. Conclusion: The present case carrying del(12)(q14q23) and an HMGA2::C12orf42 chimeric transcript strengthens the notion that involvement of HMGA2 and its misexpression are pathogenetically important in the development of aggressive angiomyxomas.Aggressive angiomyxoma was first described by Steeper and Rosai as a distinctive, infiltrating soft-tissue tumor of the pelvis and perineum in nine female patients (1). The authors used the term "aggressive angiomyxoma" to emphasize the infiltrative nature of the neoplastic blood vessels and the fact that the tumor often recurs after surgery (1). Although aggressive angiomyxoma most often arises in the vulvovaginal region, perineum, and pelvis of reproductive age women (1-9), it has also been described in the scrotum, spermatic cord, and perineum of men (10-14). The larynx, oral floor, lung, supraclavicular fossa, and liver have also very occasionally been the sites of aggressive angiomyxomas (15-21). The tumors are composed of spindle cells that are immunohistochemically positive for desmin and vimentin. Numerous thick-walled blood vessels are embedded in an abundant myxoid matrix (9,22). Over the years, cytogenetic information has been reported on only nine such tumors, all of them of vulvovaginal origin (Table I) (2,3,(5)(6)(7)(23)(24)(25)(26)(27).Herein, we report an aggressive angiomyxoma carrying a del(12)(q14q23) as the sole cytogenetic anomaly, resulting in fusion of the high mobility group AT-hook 2 (HMGA2) gene from 12q14 with the chromosome 12 open reading frame 42 (C12orf42) gene from 12q23.