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Angiomyofibroblastoma arising from the posterior perivesical space: a case report with MR findings.

Lim KJ, Moon JH, Yoon DY, Cha JH, Lee IJ, Min SJ - Korean J Radiol (2008 Jul-Aug)

Bottom Line: Angiomyofibroblastoma is a rare benign soft tissue neoplasm that predominantly occurs in the genital region of middle-aged women.We present a case of an angiomyofibroblastoma that involved the posterior perivesical space in a 48-year-old woman.We have documented the magnetic resonance imaging features of this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, College of Medicine, Hallym University, Hallym Medical Center, Seoul, Korea. cosmos952002@yahoo.co.kr

ABSTRACT
Angiomyofibroblastoma is a rare benign soft tissue neoplasm that predominantly occurs in the genital region of middle-aged women. We present a case of an angiomyofibroblastoma that involved the posterior perivesical space in a 48-year-old woman. We have documented the magnetic resonance imaging features of this case.

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Angiomyofibroblastoma in 48-year-old woman.A, B. T2-weighted axial (A) and sagittal (B) MR images show well-defined, oval shape mass with heterogeneous signal intensity in posterior perivesical space (arrows). Note nodular or curvilinear dark signal intensities within tumor.C. On T1-weighted axial MR image (10-minutes after contrast administration) at same level as in A, mass (arrows) is isointense to muscle.D-F. Contrast-enhanced dynamic sagittal MR images (D: baseline, E: 1-minute, F: 3-minute delayed image) show strong, homogeneous and persistent enhancement of mass (arrows).G. Photomicrograph of surgical specimen shows compactly arranged epithelioid ovoid or blunt spindle shaped tumor cells having monotonous small nuclei and eosinophilic cytoplasm. There are prominent ectatic blood vessels, which are surrounded by eosinophilic or myxoid fibrous stroma (Hematoxylin & Eosin staining, original magnification, ×200).H. Immunohistochemical staining shows that neoplastic cells are strongly positive (brown color) for actin (original magnification, ×200).
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Figure 1: Angiomyofibroblastoma in 48-year-old woman.A, B. T2-weighted axial (A) and sagittal (B) MR images show well-defined, oval shape mass with heterogeneous signal intensity in posterior perivesical space (arrows). Note nodular or curvilinear dark signal intensities within tumor.C. On T1-weighted axial MR image (10-minutes after contrast administration) at same level as in A, mass (arrows) is isointense to muscle.D-F. Contrast-enhanced dynamic sagittal MR images (D: baseline, E: 1-minute, F: 3-minute delayed image) show strong, homogeneous and persistent enhancement of mass (arrows).G. Photomicrograph of surgical specimen shows compactly arranged epithelioid ovoid or blunt spindle shaped tumor cells having monotonous small nuclei and eosinophilic cytoplasm. There are prominent ectatic blood vessels, which are surrounded by eosinophilic or myxoid fibrous stroma (Hematoxylin & Eosin staining, original magnification, ×200).H. Immunohistochemical staining shows that neoplastic cells are strongly positive (brown color) for actin (original magnification, ×200).

Mentions: MR imaging was performed on a Gyroscan Intera 1.5 T unit (Philips, Best, The Netherlands). Axial and coronal T1-weighted images (TR 739/TE 25) with a 5 mm slice thickness as well as axial and coronal T2-weighted images (TR 4218/TE 100) with a 5 mm slice thickness were obtained. In addition, axial and sagittal gadolinium-enhanced T1-weighted images (TR 139/TE 25) with a 5 mm slice thickness as well as sagittal dynamic gadolinium-enhanced T1-weighted images (TR 165/TE 4.6) with an 8 mm slice thickness were obtained. The mass was demonstrated as a well-defined, oval-shaped mass in the posterior perivesical space that measured 38 × 35 × 28 mm. This mass was located posterior to the inferior wall of the bladder and the upper portion of urethra and compressed both structures. Furthermore, the mass was located anterior to the vagina and uterine cervix and was separated from these structures (Fig. 1). The mass displayed heterogeneous intermediate signal intensity with focal nodular or curvilinear dark signal intensity areas within the tumor as seen on T2-weighted images (Figs. 1A, C). On T1-weighted images, the signal intensity of the mass was similar to that of skeletal muscle (Fig. 1B). After intravenous injection of gadopentetate dimeglumine (Magnevist, Schering, Erlangen, Germany), the mass showed strong and homogeneous enhancement on T1-weighted images. On contrast-enhanced dynamic MR images obtained at 30-seconds, 1-, 2-, and 3-minutes after the administration of contrast material, the mass showed fast and persistent enhancement on early and late phase images (Figs. 1D-F). The preoperative diagnosis based on these MR findings included a leiomyoma from the urinary bladder or urethra, a neurilemmoma, and a soft tissue sarcoma.


Angiomyofibroblastoma arising from the posterior perivesical space: a case report with MR findings.

Lim KJ, Moon JH, Yoon DY, Cha JH, Lee IJ, Min SJ - Korean J Radiol (2008 Jul-Aug)

Angiomyofibroblastoma in 48-year-old woman.A, B. T2-weighted axial (A) and sagittal (B) MR images show well-defined, oval shape mass with heterogeneous signal intensity in posterior perivesical space (arrows). Note nodular or curvilinear dark signal intensities within tumor.C. On T1-weighted axial MR image (10-minutes after contrast administration) at same level as in A, mass (arrows) is isointense to muscle.D-F. Contrast-enhanced dynamic sagittal MR images (D: baseline, E: 1-minute, F: 3-minute delayed image) show strong, homogeneous and persistent enhancement of mass (arrows).G. Photomicrograph of surgical specimen shows compactly arranged epithelioid ovoid or blunt spindle shaped tumor cells having monotonous small nuclei and eosinophilic cytoplasm. There are prominent ectatic blood vessels, which are surrounded by eosinophilic or myxoid fibrous stroma (Hematoxylin & Eosin staining, original magnification, ×200).H. Immunohistochemical staining shows that neoplastic cells are strongly positive (brown color) for actin (original magnification, ×200).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC2627271&req=5

Figure 1: Angiomyofibroblastoma in 48-year-old woman.A, B. T2-weighted axial (A) and sagittal (B) MR images show well-defined, oval shape mass with heterogeneous signal intensity in posterior perivesical space (arrows). Note nodular or curvilinear dark signal intensities within tumor.C. On T1-weighted axial MR image (10-minutes after contrast administration) at same level as in A, mass (arrows) is isointense to muscle.D-F. Contrast-enhanced dynamic sagittal MR images (D: baseline, E: 1-minute, F: 3-minute delayed image) show strong, homogeneous and persistent enhancement of mass (arrows).G. Photomicrograph of surgical specimen shows compactly arranged epithelioid ovoid or blunt spindle shaped tumor cells having monotonous small nuclei and eosinophilic cytoplasm. There are prominent ectatic blood vessels, which are surrounded by eosinophilic or myxoid fibrous stroma (Hematoxylin & Eosin staining, original magnification, ×200).H. Immunohistochemical staining shows that neoplastic cells are strongly positive (brown color) for actin (original magnification, ×200).
Mentions: MR imaging was performed on a Gyroscan Intera 1.5 T unit (Philips, Best, The Netherlands). Axial and coronal T1-weighted images (TR 739/TE 25) with a 5 mm slice thickness as well as axial and coronal T2-weighted images (TR 4218/TE 100) with a 5 mm slice thickness were obtained. In addition, axial and sagittal gadolinium-enhanced T1-weighted images (TR 139/TE 25) with a 5 mm slice thickness as well as sagittal dynamic gadolinium-enhanced T1-weighted images (TR 165/TE 4.6) with an 8 mm slice thickness were obtained. The mass was demonstrated as a well-defined, oval-shaped mass in the posterior perivesical space that measured 38 × 35 × 28 mm. This mass was located posterior to the inferior wall of the bladder and the upper portion of urethra and compressed both structures. Furthermore, the mass was located anterior to the vagina and uterine cervix and was separated from these structures (Fig. 1). The mass displayed heterogeneous intermediate signal intensity with focal nodular or curvilinear dark signal intensity areas within the tumor as seen on T2-weighted images (Figs. 1A, C). On T1-weighted images, the signal intensity of the mass was similar to that of skeletal muscle (Fig. 1B). After intravenous injection of gadopentetate dimeglumine (Magnevist, Schering, Erlangen, Germany), the mass showed strong and homogeneous enhancement on T1-weighted images. On contrast-enhanced dynamic MR images obtained at 30-seconds, 1-, 2-, and 3-minutes after the administration of contrast material, the mass showed fast and persistent enhancement on early and late phase images (Figs. 1D-F). The preoperative diagnosis based on these MR findings included a leiomyoma from the urinary bladder or urethra, a neurilemmoma, and a soft tissue sarcoma.

Bottom Line: Angiomyofibroblastoma is a rare benign soft tissue neoplasm that predominantly occurs in the genital region of middle-aged women.We present a case of an angiomyofibroblastoma that involved the posterior perivesical space in a 48-year-old woman.We have documented the magnetic resonance imaging features of this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, College of Medicine, Hallym University, Hallym Medical Center, Seoul, Korea. cosmos952002@yahoo.co.kr

ABSTRACT
Angiomyofibroblastoma is a rare benign soft tissue neoplasm that predominantly occurs in the genital region of middle-aged women. We present a case of an angiomyofibroblastoma that involved the posterior perivesical space in a 48-year-old woman. We have documented the magnetic resonance imaging features of this case.

Show MeSH
Related in: MedlinePlus