Endocrine Abstracts

Introduction: Aggressive angiomyxoma is a rare, benigne, misdiagnosed tumor that occurs preferentially in women during the reproductive age.

Case report: We present a 43-year-old Caucasin woman diagnosed with aggressive multifocal angomyxoma developing for the last 8 years. The patient underwent five surgical procedures during this period of time in order to debulk the pelvis and subperitoneal space of a large invasive tumor. The last surgical approach revealed a gigantic tumor of elastic consistency that presented perirectal, periuterin and perivaginal extension. Also, the tumor expanded in the right iliac fossa and further to the femoral ring. In addition to hysterectomy with bilateral salpingo-oophorectomy due to its increased size and the invasive character, a massive resection of the tumor was performed. The histopathological and immunohistochemical staining confirmed the aggressive angiomyxoma with intense positive reaction for estrogen and progesterone receptors and a proliferation index (ki67%) of 3%. The 3 months postoperative evaluation consisting in abdominal and pelvic IRM revealed no tumor reccurence.

Conclusion: Despite its benign features, the aggressive angiomyxoma should be regarded as a tumor with a high tendency to reccurence. The lack of specificity of its clinical presentation can lead to a delay in diagnosis. The angiomyxoma should be considered as a possible diagnosis in incidental finding of a mass in the pelvic or genital area in women of reproductive age.