Hormonal therapy for aggressive angiomyxoma: a case report and proposed management algorithm

Area of Science:

• Gynecologic Oncology
• Endocrinology
• Oncologic Surgery

Background:

• Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor.
• AAM often presents with pelvic or vulvar masses and has a high recurrence rate.
• Hormonal therapy is increasingly recognized as a treatment modality for AAM.

Observation:

• A patient with recurrent aggressive angiomyxoma experienced disease control with long-term hormonal therapy using gonadotropin-releasing hormone analogs.
• Tumor recurrence was noted after a short course of therapy, but sustained remission was achieved with prolonged treatment.
• Literature review indicates AAM is estrogen and progesterone receptor-positive, suggesting hormonal sensitivity.

Findings:

• Hormonal therapy, including gonadotropin-releasing hormone analogs and aromatase inhibitors, can be effective in managing aggressive angiomyxoma.
• Treatment selection should consider tumor receptor status (ER/PR), disease extent, and patient menopausal status.
• Long-term hormonal therapy may be necessary for sustained disease control in recurrent or extensive AAM.

Implications:

• Hormonal therapy offers a viable treatment option for aggressive angiomyxoma, particularly in cases of recurrence or extensive disease.
• Personalized management strategies incorporating hormonal agents can improve outcomes for AAM patients.
• Further research into optimal hormonal regimens and long-term efficacy is warranted.