Aggressive angiomyxoma of vulva recurring 8 years after initial diagnosis

Abstract

Aggressive angiomyxoma should be kept in mind when an asymptomatic and slow-growing vulvar mass is detected in young females. The surgery should aim wide local excision and long-term follow-up is necessary due to high rate of local recurrence.

Aggressive angiomyxoma of the vulva – A rare entity

“…Immunohistochemically, the tumor cells are positive for vimentin and may stain for smooth muscle actin and desmin. The differential diagnosis of AA included myxomas, angiomyofibroblastoma, fibroepithelial stromal polyp, superficial angiomyxoma, myxoid neurofibroma, myxoid liposarcoma, myxoid variant of malignant fibrous histiocytoma, sarcoma botryoides and myxofibrosarcoma [9,10] (Table 1).…”

“…Incomplete resection is acceptable where fertsility is to be preserved as local recurrences can be treated with further resection. Tamoxifen, raloxifene and gonadotropin-releasing hormone analogues can be used to reduce the tumor size, thus helping to make complete excision feasible in large tumors [7,10]. They are also used in the treatment of recurrence.…”

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“…GnRH agonists can also be used preoperatively to shrink tumors and increase the chance for complete excision [41]. AA has a high rate of local recurrence [42]. Recurrence has been reported anywhere between two months to fifteen years after initial surgical resection [3].…”

A rare case of aggressive angiomyxoma of vulva since childhood

“…Preoperative angiographic embolization, 18 external beam irradiation, and intra operative electron beam radiotherapy have been used to decrease local recurrence. 19 Recurrences may occur from months to years with maximal incidence during the first two years (70%), though cases have been reported with recurrences after 8 years 20 and 20 years. 21,22 Therefore all cases should be followed minimum upto 2 years though lifetime follow up is warranted.…”