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Transperineal aggressive angiomyxoma.
Pedro Pereira1, Elisa Melo Abreu2, Teresa Margarida Cunha1
1Department of Radiology, Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisbon, Portugal.
BMJ Case Reports
|April 13, 2017
Summary
A large gluteal mass in a woman with a history of hysterectomy was diagnosed as aggressive angiomyxoma. Surgical excision confirmed the diagnosis, highlighting the importance of imaging in identifying rare pelvic tumors.
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.