Complete Resection of a Giant Aggressive Angiomyxoma Using a Rotation Flap: A Case Report

Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor characterized by locally infiltrative growth and a relatively high rate of local recurrence. Surgical management requires careful planning and tailored operative strategies to achieve negative resection margins while preserving adjacent organs. We report a case of AAM treated with complete surgical resection using a rotation flap technique while preserving the surrounding organs.

A 58-year-old woman presented to her primary physician with elevated serum carcinoembryonic antigen levels, and physical examination revealed a subcutaneous mass on the right buttock. Needle biopsy confirmed the diagnosis of AAM. Gonadotropin-releasing hormone agonist therapy with leuprorelin was administered for 1 month; however, no tumor reduction was observed. Therefore, a surgical excision was planned. To achieve tumor removal with negative margins while preserving the surrounding organs, we collaborated with the plastic surgery team and employed a rotation flap technique, which provided excellent surgical exposure and facilitated wound closure. The lesion was completely resected with negative margins, and histopathological examination confirmed the diagnosis of AAM. The patient remains alive without evidence of recurrence 1 year postoperatively.

The present case suggests that rotation flap reconstruction may be a useful option for the surgical management of large perineal or gluteal tumors, such as AAM. This technique allows for a flexible skin incision design, facilitates adequate surgical exposure, and enables reliable wound closure with minimal invasiveness.