OJOG  Vol.3 No.8 , October 2013
Aggressive angiomyxoma pelvis presenting as an ovarian tumor
Abstract: Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and its frequent association with local recurrence. Preoperative diagnosis and treatment may be difficult. We report a 55-year-old patient who presented with a pelvic mass with no significant medical history. The radiological assessment showed a pelvic cystic tumor retro and lateral bladder. A surgical excision was performed with a diagnosis of aggressive angiomyxoma pelvis that misdiagnosed as ovarian tumor. The patient received adjuvant radiotherapy after surgery and remains well with no signs of local recurrence at 12 months follow-up. As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery can not be overemphasized. The authors discuss this finding through the diagnostic difficulties and the evolution of this entity.
Cite this paper: Sanaa, E. , Safae, L. , Samia, M. , Hinde, E. , Hanane, S. , Nadia, S. , Chahrazed, B. , Afaf, A. and Abdelaziz, B. (2013) Aggressive angiomyxoma pelvis presenting as an ovarian tumor. Open Journal of Obstetrics and Gynecology, 3, 621-624. doi: 10.4236/ojog.2013.38111.

[1]   McCluggage, W.G. (2005) A review and update of morphologically bland vulvovaginal mesenchymal lesions. International Journal of Gynecologic Pathology, 24, 26-38.

[2]   Nucci, M.R. and Fletcher, C.D. (2000) Vulvovaginal soft tissue tumors: Update and review. Histopathology, 36, 97-108.

[3]   Steeper, T.A. and Rosai, J. (1983) Aggressive angiomyxoma of the female pelvis and perineum: Report of nine cases of a distinctive type of gynecologic soft-tissue neoplasm. American Journal of Surgical Pathology, 7 463-475.

[4]   Nucci, M.R., Granter, S.R. and Fletcher, C.D. (1997) Cellular angiofibroma: A benign neoplasm distinct from aggressive angiomyxoma. American Journal of Surgical Pathology, 21, 636-644.

[5]   Chan, Y.M., Hon, E., Ngai, S.W., Ng, T.Y. and Wong, L.C. (2000) Aggressive angiomyxoma in females: Is radical resection the only option? Acta Obstetricia et Gynecologica Scandinavica, 79, 216-220.

[6]   Fetsch, J.F., Laskin, W.B., Lefkowitz, M., Kindblom, L.G. and Meis-kindblom, J.M. (1996) Aggressive angiomyxoma: A clinicopathologic study of 29 female patients. Cancer, 78, 79-90.<79::AID-CNCR13>3.0.CO;2-4

[7]   Bigby, S.M., Symmans, P.J., Miller, M.V., Drays, M.S. and Jones, R.W. (2011) Aggressive angiomyxoma of the female genital tract and pelvis clinicopathologic features with immunohistochemical analysis. International Journal of Gynecologic Pathology, 30, 505-513. 0b013e318211d56c

[8]   Behranwaha, K.A. and Thomas, J.M. (2003) Aggressive angiomyxoma: A distinct clinical entity. European Journal of Surgical Oncology, 29, 559-563.

[9]   Rhombrg, W., Jasarevic, Z., Alton, R., Kompatscher, P., Beer, G. and Breitfellner, G. (2000) Aggressive angiomyxoma: Irradiation for recurrent disease. Strahlentherapie und Onkologie, 176, 324-326.

[10]   Suleiman, M., Duc, C., Ritz, S. and Beieri, S. (2006) Pelvic excision of large aggressive angiomyxoma in a woman: Irradiation for recurrent disease. International Journal of Gynecological Cancer, 16, 356-360.

[11]   Fine, B.A., Munoz, A.K., Ltz, C.E. and Gershenson, D.M. (2001) Primary medical management of recurrent aggressive angiomyxoma of the vulva with a gonadotropin-releasing hormone agonist. Gynecologic Oncology, 81, 120-122.

[12]   McCluggage, W.G., Jamieson, T., Dobbs, S.P. and Grey, A. (2006) Aggressive angiomyxoma of the vulva: Dramatic response to gonadotropin-releasing hormone agonist therapy. Gynecologic Oncology, 100, 623-625.