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Alternative surgical approaches for aggressive angiomyxoma at different sites in the pelvic cavity.

Choi H, Park C, Ji YI - Obstet Gynecol Sci (2015)

Bottom Line: It is slow growing, locally infiltrative, and has a high risk of local recurrence and the neoplastic character of blood vessels.The standard treatment is surgery.To date, no relapse has been observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT
Aggressive angiomyxoma, a rare soft tissue benign neoplasm, predominantly occurs in the female pelvic peritoneum and perineum region during reproductive age. It is slow growing, locally infiltrative, and has a high risk of local recurrence and the neoplastic character of blood vessels. The standard treatment is surgery. We report three unusual aggressive angiomyxoma cases. The first case was a pedunculated mass of the left labium major; the second, a left perineal mass that infiltrated into the paravesical area via the obturator foramen; and the third, a big mass in the retroperitoneal cavity, found that growing aggressive angiomyxoma looked like lava expulsion in the pelvic area. After a thorough examination and full radiologic workup, we performed surgical excision in each patient via different approaches. Histopathologic findings were consistent with diagnosis of aggressive angiomyxoma. To date, no relapse has been observed.

No MeSH data available.


Related in: MedlinePlus

Aggressive angiomyxoma: gross finding. (A) Case 1. A huge perineal mass that reveals aggressive angiomyxoma. (A-a,b) A huge polypoid pedunculated mass that measures 27 cm, with an attached stalk and overlying skin on the left labium is observed. (A-c,d) The mass shows a glistening surface and gelatinous cut surface. (B) Case 2. The retroperitoneal aggressive growth looks like lava expulsion. (B-a) The image shows the pelvic brim. (B-b) The image shows the left adnexal area and posterior cul-de-sac. (B-c) The image shows the protruding mass in the right pelvic retroperitoneum. (B-d) The image shows the excised tumor. (C) Case 3. The tumor lesion extended from the left paravesical space and obturator space, retroperitoneum to the left buttock. (C-a,b) External showing of mass on left labium major to left buttock. (C-c,d) Mass removed from retroperitoneal space which extended to paravesical and obtulator space, over 20-cm-sized irregular shaped.
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Figure 1: Aggressive angiomyxoma: gross finding. (A) Case 1. A huge perineal mass that reveals aggressive angiomyxoma. (A-a,b) A huge polypoid pedunculated mass that measures 27 cm, with an attached stalk and overlying skin on the left labium is observed. (A-c,d) The mass shows a glistening surface and gelatinous cut surface. (B) Case 2. The retroperitoneal aggressive growth looks like lava expulsion. (B-a) The image shows the pelvic brim. (B-b) The image shows the left adnexal area and posterior cul-de-sac. (B-c) The image shows the protruding mass in the right pelvic retroperitoneum. (B-d) The image shows the excised tumor. (C) Case 3. The tumor lesion extended from the left paravesical space and obturator space, retroperitoneum to the left buttock. (C-a,b) External showing of mass on left labium major to left buttock. (C-c,d) Mass removed from retroperitoneal space which extended to paravesical and obtulator space, over 20-cm-sized irregular shaped.

Mentions: A 49-year-old woman presented with a large vulvar mass. She previously had a much smaller vulvar mass for a year, and had been asymptomatic. The size of the mass suddenly increased in a month. Examination revealed a large polypoid pedunculated mass arising from the left labium major, with ulceration and secondary infection (Fig. 1A-a, b). There were no palpable masses upon examination of the abdominal and groin areas. Pelvic computed tomography revealed a bulging mass (19×19 cm), with mild non-homogeneous enhancement along the ventral margin of the pelvic wall and major labium. No pelvic mass was observed; there was no free fluid or hydronephrosis. The mass was excised using a 1-cm lateral margin, with the patient under general anesthesia. No recurrence has been observed 4 years after excision.


Alternative surgical approaches for aggressive angiomyxoma at different sites in the pelvic cavity.

Choi H, Park C, Ji YI - Obstet Gynecol Sci (2015)

Aggressive angiomyxoma: gross finding. (A) Case 1. A huge perineal mass that reveals aggressive angiomyxoma. (A-a,b) A huge polypoid pedunculated mass that measures 27 cm, with an attached stalk and overlying skin on the left labium is observed. (A-c,d) The mass shows a glistening surface and gelatinous cut surface. (B) Case 2. The retroperitoneal aggressive growth looks like lava expulsion. (B-a) The image shows the pelvic brim. (B-b) The image shows the left adnexal area and posterior cul-de-sac. (B-c) The image shows the protruding mass in the right pelvic retroperitoneum. (B-d) The image shows the excised tumor. (C) Case 3. The tumor lesion extended from the left paravesical space and obturator space, retroperitoneum to the left buttock. (C-a,b) External showing of mass on left labium major to left buttock. (C-c,d) Mass removed from retroperitoneal space which extended to paravesical and obtulator space, over 20-cm-sized irregular shaped.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663234&req=5

Figure 1: Aggressive angiomyxoma: gross finding. (A) Case 1. A huge perineal mass that reveals aggressive angiomyxoma. (A-a,b) A huge polypoid pedunculated mass that measures 27 cm, with an attached stalk and overlying skin on the left labium is observed. (A-c,d) The mass shows a glistening surface and gelatinous cut surface. (B) Case 2. The retroperitoneal aggressive growth looks like lava expulsion. (B-a) The image shows the pelvic brim. (B-b) The image shows the left adnexal area and posterior cul-de-sac. (B-c) The image shows the protruding mass in the right pelvic retroperitoneum. (B-d) The image shows the excised tumor. (C) Case 3. The tumor lesion extended from the left paravesical space and obturator space, retroperitoneum to the left buttock. (C-a,b) External showing of mass on left labium major to left buttock. (C-c,d) Mass removed from retroperitoneal space which extended to paravesical and obtulator space, over 20-cm-sized irregular shaped.
Mentions: A 49-year-old woman presented with a large vulvar mass. She previously had a much smaller vulvar mass for a year, and had been asymptomatic. The size of the mass suddenly increased in a month. Examination revealed a large polypoid pedunculated mass arising from the left labium major, with ulceration and secondary infection (Fig. 1A-a, b). There were no palpable masses upon examination of the abdominal and groin areas. Pelvic computed tomography revealed a bulging mass (19×19 cm), with mild non-homogeneous enhancement along the ventral margin of the pelvic wall and major labium. No pelvic mass was observed; there was no free fluid or hydronephrosis. The mass was excised using a 1-cm lateral margin, with the patient under general anesthesia. No recurrence has been observed 4 years after excision.

Bottom Line: It is slow growing, locally infiltrative, and has a high risk of local recurrence and the neoplastic character of blood vessels.The standard treatment is surgery.To date, no relapse has been observed.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.

ABSTRACT
Aggressive angiomyxoma, a rare soft tissue benign neoplasm, predominantly occurs in the female pelvic peritoneum and perineum region during reproductive age. It is slow growing, locally infiltrative, and has a high risk of local recurrence and the neoplastic character of blood vessels. The standard treatment is surgery. We report three unusual aggressive angiomyxoma cases. The first case was a pedunculated mass of the left labium major; the second, a left perineal mass that infiltrated into the paravesical area via the obturator foramen; and the third, a big mass in the retroperitoneal cavity, found that growing aggressive angiomyxoma looked like lava expulsion in the pelvic area. After a thorough examination and full radiologic workup, we performed surgical excision in each patient via different approaches. Histopathologic findings were consistent with diagnosis of aggressive angiomyxoma. To date, no relapse has been observed.

No MeSH data available.


Related in: MedlinePlus