Aggressive Angiomyxoma of the Female External Genitalia

Abstract

Aggressive angiomyxoma (AAM) is a rare and benign mesenchymal tumor that localizes predominantly in the female pelvis. Its invasive growth and local recurrence are challenging for professionals. Histologically, AAM is a tumor with a myxoid stroma that is highly vascular and hypocellular. The diagnosis is made relatively late due to nonspecific symptoms. Treatment of AAM is extensive local surgical excision with intact resection lines. Gonadotropin-releasing hormone agonists are added postoperatively. The prognosis is good and metastasis is rare. We present a case of an aggressive angiomyxoma located in the left greater labial area in a 50-year-old woman. After discussion and informed consent signed by the patient, on 27.01.2023 at the University Hospital “St. Marina” Pleven, the patient was admitted to the hospital. The tumor was extirpated under epidural anaesthesia on the date of the patient's informed consent. The patient was prescribed postoperative therapy with Zoladex 3,6 mg implant according to the schedule.The patient was subjected to monthly gynecological check-ups for one year after the surgical intervention. To date, no recurrence of the underlying disease has been detected. Long-term results show a good trend. In conclusion, we can say that the optimal treatment of AAM is wide local excision. It is not recommended to aim for radicality because of the risk of postoperative complications. Postoperative administration of GnRH-a is advisable to avoid recurrences. All patients undergo regular follow-up examinations for long-term follow-up.

Keywords

• aggressive angiomyxoma
• soft tissue tumors