Aggressive Angiomyxoma in the Anus of Elderly Male

Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor characterized by local invasion and a high recurrence rate, primarily affecting the pelvic-perineal region in women. It is extremely rare in men. Although male-onset cases are typically reported in the scrotum or buttocks, there have been no previously reported cases involving the anus. We report the first such case in a 71-year-old man initially diagnosed with prolapsed internal hemorrhoids (Goligher grade IV). The patient underwent surgical treatment; however, histological analysis of the specimen unexpectedly revealed AAM, with positive findings for CD34 (+), desmin (+), and partially positive ER (ER [partial +]). The postoperative course was complicated by hemorrhage, requiring hemostasis via vascular embolization. Despite the high recurrence rate of AAM, the patient has remained disease-free for over five years.