Transperineal aggressive angiomyxoma

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Uterine leiomyomas are common benign tumors, and hysterectomy with adnexal preservation is a standard treatment.
• Aggressive angiomyxoma is a rare mesenchymal tumor typically occurring in the pelvis and perineum of adult women.

Observation:

• A 45-year-old woman presented with a progressively enlarging right gluteal mass over 6 months.
• Radiological imaging revealed a large (14 cm) lesion with translevator growth, displacing adjacent structures.
• MRI showed a characteristic whorled pattern on T2-weighted images with gadolinium enhancement.

Findings:

• CT-guided biopsy and imaging features suggested aggressive angiomyxoma.
• Surgical excision confirmed the diagnosis of aggressive angiomyxoma.

Implications:

• This case underscores the importance of comprehensive radiological assessment for diagnosing rare pelvic tumors.
• Early and accurate diagnosis through combined imaging and biopsy is crucial for effective management of aggressive angiomyxoma.
• Adnexal preservation during hysterectomy does not preclude the development of rare pelvic soft tissue tumors.