Aggressive angiomyxoma of the vagina: Case report and review of the literature
DOI:
https://doi.org/10.18597/rcog.3527Abstract
Objectives: To present the case of a patient diagnosed with aggressive angiomyxoma of the vagina and to conduct a review of the diagnosis, treatment and prognosis of this disease condition. Materials and Methods: A 46-year old female patient complaining of dysuria and vaginal mass sensation. Physical exploration and imaging studies revealed a tumor extending into the pelvic cavity. The mass was resected through a vaginal approach and pathology of the surgical specimen showed a aggressive angiomyxoma of the vagina. New retrorectar surgery was performed three months after the initial resection because of recurrence. A search was conducted in the Medline via PubMed, Lilacs, Scielo and Google Scholar databases using the terms “Angiomyxoma,” “Aggressive” and “Vagina.” The search included review articles, case reports and case series published in English and Spanish since 1995. The information extracted included diagnosis, symptoms, signs, immunohistochemistry and imaging studies used, type of treatment - surgical or other - and prognosis. Findings are described in narrative form. Results: Overall, 23 titles were identified, of which 14 case reports, 2 clinical case series and 1 review article met the inclusion criteria. Sixty-five per cent of the patients were between 30 and 50 years of age. Diagnosis was made by immunohistochemistry in 8 cases, and diagnostic imaging was used in 12 cases. Computed tomography showed sharper contours of the lesions. Surgical treatment was applied in all reports, supplemented by hormonal therapy in 4 cases. There was follow-up in 14 of the 17 cases reported. Conclusion: Aggressive angiomyxoma of the vagina is rare. Assessment of the role of various immunohistochemical tests is needed in cases identified as aggressive angiomyxoma on histopathology. Evaluation of hormonal treatment as an adjunct to surgery is required. Prognosis is good.
Author Biographies
Diana Meliza Hidalgo-Zambrano, Universidad Surcolombiana, Neiva (Colombia).
Residente de Ginecología y Obstetricia, Universidad Surcolombiana, Neiva (Colombia).
Daniel Felipe Reyes-Vega, Hospital Universitario Hernando Moncaleano Perdomo, Neiva (Colombia).
Médico general, Hospital Universitario Hernando Moncaleano Perdomo, Neiva (Colombia).
Luis Guillermo Cano-Arias, Hospital Universitario Hernando Moncaleano Perdomo, Neiva (Colombia).
Docente del Departamento de Ginecología, Universidad Surcolombiana, Unidad de Ginecología Oncológica, Hospital Universitario Hernando Moncaleano Perdomo, Neiva (Colombia).
References
Chan I, Hon E, Ngai SW, Ng TY, Wong L. Aggressive angiomyxoma in females: Is radical resection the only option? Acta Obstet Gynecol Scand. 2000;79:216-220. https://doi.org/10.1080/j.1600-0412.2000.079003216.x
Fletcher CDM, Unni KK, Mertens F., editors. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon: IARC Press; 2002.
Sutton BJ, Laudadio J. Aggressive angiomyxoma. Arch Pathol Lab Med. 2012;136(2):217-21. https://doi.org/10.5858/arpa.2011-0056-RS
Iezzoni JC, Fechner RE, Wong LS, Rosai J. Aggressive angiomyxoma in males. A report of four cases. Am J Clin Pathol. 1995;104(4):391-6. https://doi.org/10.1093/ajcp/104.4.391
Steeper TA, Rosai J. Aggressive angiomyxoma of the female pelvis and perineum. Report of nine cases of a distinctive type of gynecologic soft-tissue neoplasm. Am. J. Surg. Pathol. 1983;7(5):463-75. https://doi.org/10.1097/00000478-198307000-00009
Blandamura S, Cruz J, Faure -Vergara L, Machado-Puerto I, Ninfo V. Aggressive angiomyxoma: A second case of metastasis with patient’s death. Hum Pathol. 2003;34(10):1072-4. https://doi.org/10.1053/s0046-8177(03)00419-2
Siassi RM, Papadopoulos T, Matzel KE. Metastasizing aggressive angiomyxoma. N Engl J Med. 1999;341(23):1772. https://doi.org/10.1056/nejm199912023412315
Hajjar R, Alharthi M, Richard C, Gougeon F, Loungnarath R. Pelvic aggressive angiomyxoma: Major challenges in diagnosis and treatment. Cureus. 2019;11(4):e4419. https://doi.org/10.7759/cureus.4419
Fetsch JF, Laskin WB, Lefkowitz M, Kindblom LG, Meis-Kindblom JM. Aggressive angiomyxoma: A clinicopathologic study of 29 female patients. Cancer. 1996;78(1):79-90. https://doi.org/10.1002/(SICI)1097-0142(19960701)78:1<79::AIDCNCR13>3.0.CO;2-4
Haldar K, Martinek IE, Kehoe S. Aggressive angiomyxoma: A case series and literature review. Eur J Surg Oncol. 2010;36(4):335-9. https://doi.org/10.1016/j.ejso.2009.11.006
Amezcua CA, Begley SJ, Mata N, Felix JC, Ballard CA. Aggressive angiomyxoma of the female genital tract: A clinicopathologic and immunohistochemical study of 12 cases. Int J Gynecol Cancer. 2005;15(1):140-5. https://doi.org/10.1111/j.1048-891x.2005.15015.x
Jeyadevan NN, Sohaib SAA, Thomas JM, Jeyarajah A, Shepherd JH, Fisher C. Imaging features of aggressive angiomyxoma. Clin Radiol. 2003;58(2):157-62. https://doi.org/10.1053/crad.2002.1127
McCluggage WG, Jamieson T, Dobbs SP, Grey A. Aggressive angiomyxoma of the vulva: Dramatic response to gonadotropin-releasing hormone agonist therapy. Gynecol Oncol. 2006;100(3):623-5. https://doi.org/10.1016/j.ygyno.2005.09.033
Bai HM, Yang JX, Huang HF, Cao DY, Chen J, Yang N, Lang JH, Shen K. Individualized managing strategies of aggressive angiomyxoma of female genital tract and pelvis. Eur J Surg Oncol. 2013;39(10):1101-8. https://doi.org/10.1016/j.ejso.2013.06.013
Carta G, Parisse V, Accurti V, Sollima L, Di Stefano L, Alfonso DA, et al. Aggressive angiomyxoma of the vaginal wall at the initial stage: A case report. Europ J Gynaecol Oncol. 2012;33(6):669-71.
Lourenço C, Oliveira N, Ramos F, Ferreira I, Oliveira M. Aggressive angiomyxoma of the vagina: A case report. Rev Bras Ginecol Obstet. 2013;35(12):575-82. https://doi.org/10.1590/s0100-72032013001200008
Chauhan MB, Malhotra V, Dahiya P, Nanda S. Aggressive angiomyxoma of the vagina masquerading as genital prolapse. J Gynecol Surg. 2010;26(4: 277-9. https://doi.org/10.1089/gyn.2009.0044
Jiménez-Vieyra CR, Quintana-Romero V, Aguilera-Maldonado LV, Solís-Moreno TK. Angiomixoma agresivo de vagina: un tumor poco diagnosticado. Ginecol Obstet Mex. 2013;81(7):403-8.
Wang YF, Qian HL, Jin HM. Local recurrent vaginal aggressive angiomyxoma misdiagnosed as cellular angiomyofibroblastoma: A case report. Exp Ther Med. 2016;11(5):1893-5. https://doi.org/10.3892/etm.2016.3097
Erol B, Pelit ES, Bektaş S, Şimşek A. Aggressive vaginal angiomyxoma mimicking a bladder mass. Urol J. 2014;11(3):1710-3. https://doi.org/10.22037/uj.v11i3.2069
Shahid N, Ahluwalia A, Sahasrabudhe N, Davenport A. Aggressive angiomyxoma of the vagina: A rare differential diagnosis of a lateral vaginal wall cyst. J Obstet Gynaecol. 2005;25(6):622-3. https://doi.org/10.1080/01443610500243802
Stumpf AM, Stival SM, Merlini AB, Mansani FP, Silvestre JBCH, Mongruel IB, et al. Aggressive angiomyxoma of the vagina: A case report. J Bras Patol Med Lab. 2016;52(1):35-8. https://doi.org/10.5935/1676-2444.20160011
Seppings SC, Samir H, Abdelrahman I. An unusual vaginal lump. BMJ Case Rep. 2017; 2017:bcr2016218027. https://doi.org/10.1136/bcr-2016-218027
Cinel L, Taner D, Nabaei M, Dogan M. Aggressive angiomyxoma of the vagina: Report of a distinctive type gynecologic soft tissue neoplasm. Acta Obstet Gynecol Scan. 2000;79(3):232-3. https://doi.org/10.1080/j.1600-0412.2000.079003232.x
Larouche M, Hague CJ, Masoudi H, Geoffrion R. Aggressive angiomyxoma presenting as massive irreducible vaginal prolapse. Int Urogynecol J. 2016;27(12):1933-4. https://doi.org/10.1007/s00192-016-3112-7
Amr SS, El-Mallah KO. Aggressive angiomyxoma of the vagina. Int J Gynecol Obstet. 1995;48(2):207-10. https://doi.org/10.1016/0020-7292(94)02266-2
Gonzaga LF, Freitas CM, Tavares JM. Aggressive vaginal angiomyxoma mimicking urethral tumor. Int Braz J Urol. 2005;31(5):475-6. https://doi.org/10.1590/s1677-55382005000500011
Manandhar T, Sitaula S, Dixit B, Takur A. Angiomyxoma of the vagina mimicking as episiotomy scar endometriosis. A case report. European J Biomed Pharm Sci. 2019;(12):271-3.
Güngör T, Zengeroğlu S, Kaleli A, Kuzey G M. Aggressive angiomyxoma of the vulva and vagina. Eur J Obstet Gynecol Reprod Biol. 2004;112(1):114-6. https://doi.org/10.1016/s0301-2115(03)00270-7
Dahiya K, Jain S, Duhan N, Nanda S, Kundu P. Aggressive angiomyxoma of vulva and vagina: A series of three cases and review of literature. Arch Gynecol Obstet. 2010;283(5):1145-48. https://doi.org/10.1007/s00404-010-1575-1
Herrera-Castro JC, González-Calderón G, Medina-Franco H. Angiomixoma agresivo: reporte de un caso y experiencia global con 168 casos. Ginecol Obstet Mex. 2017;85(11):755-62. https://doi.org/10.24245/gom.v85i11.1504
Piura B, Shaco-Levy R. Pedunculated aggressive angiomyxoma arising from the vaginal suburethral area: Case report and review of literature. Eur J Gynaecol Oncol. 2005;26(5):568-71.
Zhu H, Wang S. Aggressive angiomyxoma of the vagina. Chin Med J (Engl). 2014;127(5):998.
Papachristou DJ, Batistatou A, Paraskevaidis E, Agnantis NJ. Aggressive angiomyxoma of the vagina: A case report and review of the literature. Eur J Gynaecol Oncol. 2004;25(4):519-21. PMID: 15285321.
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