Aggressive angiomyxoma in pregnancy.

Area of Science:

• Gynecologic Oncology
• Pathology
• Medical Imaging

Background:

• Aggressive angiomyxoma (AA) is a rare, slow-growing mesenchymal neoplasm predominantly affecting the vulvo-perineal region in women of reproductive age.
• While common in this demographic, documented cases of AA during pregnancy are scarce.
• AA has a high propensity for local recurrence, often linked to incomplete surgical excision.

Observation:

• A case of a 25-year-old pregnant female presenting with a painless, soft vulvar mass was observed.
• The mass, initially suspected to be a lipoma, was attached to the left labia majora by a stalk.
• The lesion was completely excised and subsequently diagnosed as aggressive angiomyxoma via histopathology.

Findings:

• Histopathological examination confirmed the diagnosis of aggressive angiomyxoma.
• The preoperative clinical diagnosis of lipoma was incorrect, highlighting diagnostic challenges.
• Complete excision was achieved, but the potential for recurrence remains a concern.

Implications:

• Gynecologists should maintain a high index of suspicion for aggressive angiomyxoma in young, pregnant women presenting with vulvo-perineal masses.
• Accurate preoperative diagnosis is critical to ensure complete excision and minimize the risk of local recurrence.
• Increased awareness and prompt diagnosis can improve patient outcomes for this rare condition.