It has been reported in male and female children as young as 2 years old 2, 3, 5. About 2 years later Begin published his experience with 9 patients which included the first report of this entity among men 5. According to our view, partial resection should only be considered in cases refusing these surgical risks or in the presence of unresectable tumor. The tumor has exerted pressure on the bladder, the left ureter, uterus, and left iliac vein. This is a relatively rare tumor that most surgeons will not find in their careers 8 , and the fact that the case presented here is that of a male patient reinforces its unusual nature There are occasional nucleoli and very little mitosis occurs. Some cases have been reported with diffusely infiltrative margins.
They are most commonly found in pelvic locations in women. Although the majority of the authors have reported no advantage in using radiotherapy, it can be a good alternative treatment in patients who are resistant to antihormonal therapy, those with recurrence or in whom tumor resection would cause high morbidity. A year-old female patient who previously underwent surgery for left femoral hernia operation resulting in surgical failure was reoperated for a giant AA located in the pelvis. Cosmetic results are satisfactory as a consequence of the approach selected, and there are no alterations in anorectal continence. Aggressive angiomyxoma occurs much more frequently among women than in men, among whom it is rare. The diagnosis of AA is very difficult because it is often asymptomatic until the tumor reaches large sizes. Moreover, the optimal duration of therapy is unknown.
It is important to differentiate angiomyxoma from angiomyofibroblastoma of the vulva which shares histogenic features with it. Case Presentation A year-old nulliparous female patient with a previous history of left femoral hernia operation was admitted to our hospital.
On exploration, a giant, soft, rubbery, and gelatinous appearing mass like lung tissue that approximately filled the whole abdomen was noted. According to our view, partial resection should only be considered in cases refusing these surgical risks or in the presence of unresectable tumor. The mass was also extended to the one-third upper level of left thigh. Angiomyxomaa immunohistochemical findings of the present tumor confirmed positivity for both estrogen and progesterone receptors.
Laparotomy was performed through a midline incision that extends to the left thigh.
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Management requires complete removal of the lesion and the clinical and imaging follow-up given their high rate of recurrence. FOLLOW-UP Follow-up examinations at intervals of one to two years in which ultrasound and MRI examinations are alternated are sufficient, given the slow growth and low likelihood of metastasis of this tumor 3. Exploratory laparotomy was planned. View at Google Scholar J. It is noteworthy that there is still a lack of knowledge about the clinical presentation, the management options, and the follow-up results of AA in the current literature.
In view of these findings, we think that there is still a lack of knowledge about the diagnosis of AA among the clinicians.
Aggressive angiomyxoma: A case series and literature review
Accordingly, she was referred z our clinic because of surgical failure. Chemotherapy yields no beneficial results for adjuvant therapy because of low mitotic activity of the tumor.
This established the diagnosis of a presacral tumor Figure 1. Also, the tumor size is not correlated with recurrence.
In general, these lesions occur in the pelvis, perineum and inguinal region An immobile, painless mass which filled lower quadrants of the abdomen was palpated. Unusual Abdominal and Pelvic Tumors.
Aggressive angiomyxoma: a case series and literature review.
This is an open access article distributed under the Creative Commons Angoimyxoma Licensewhich permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Cqse abdominal-pelvic MRI showed the presence of an 8.
There are also reports of cases in the retrovesical region, prostate and epididymis 5, 7, 10, 11, The rectum is fully mobilized to the plane of the elevators muscles, and then the mass in adjacent planes is dissected. It has been established that fewer than of the cases were reported in the English language literature between and 2.
Case Reports in Surgery
Thus, extensive surgery can be disregarded in patients with high morbidity and for preserving fertility, as well. Since tumors are usually large, contiguous involvement of several sites is common 5. On T1-weighted MR imaging, the tumor shows isosignal compared to the muscles while on T2 high signal intensity is detected. AA should be considered in the differential diagnosis of any painless swelling located in the genitofemoral region, particularly in women of reproductive age.
Can J Plast Surg ; The most common clinical symptom is painless swelling at vulva or groin area. Clinically measurable response requires 3 to 4 months 2, 6, 10, 14, In view of these data, the demographic characteristic and the tumor localization of our patient were similar to the majority of previously reported cases.
Presentation of the presacral tumor after performing digital dissection of retrorectal space. The tumor is distinguished from other lesions by these histopathologic features. Immunohistochemically, the cells show positive staining with vimentin, desmin, estrogen, and progesterone receptor.