Aggressive angiomyxoma of the vulva treated by using a gonadotropin- releasing hormone agonist: A case report

Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
European journal of gynaecological oncology (Impact Factor: 0.61). 01/2011; 32(6):686-8.
Source: PubMed


A rare case of a 38-year-old woman with progesterone receptor-positive aggressive angiomyxoma is presented. She underwent local excision and was treated with a gonadotropin-releasing hormone agonist as adjuvant therapy, and is free of disease 20 months after.

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    ABSTRACT: Background: The purpose of this study was to assess the value of conservative surgery in aggressive angiomyxoma (AA) in our institutional series. Method: This was a retrospective review of patients with AA treated at our institution between 1999 and 2010. Results: Fourteen consecutive patients were analyzed: 8 primary tumors and 6 recurrences. Female/male ratio was 13:1; median female age was 36 years. Median size of primary lesions was 12 cm (range, 7-17 cm). Median size of recurrences was 20.5 cm (range, 3-44 cm). Twelve patients were operated on. Two asymptomatic patients whose surgery would have been mutilating were placed under wait and see. Four patients had concomitant visceral resections because of massive infiltration. No tumor rupture was recorded on pathological examination. Margins were R0 (n = 2), R1 (n = 10), and R2 (n = 0). Seven patients (50%) received radiotherapy. Median postoperative follow-up was 69 months, and no patient was lost at follow-up. All patients operated on (primaries and recurrences) had no evidence of recurrence. Conclusion: Conservative and planned en bloc surgery achieves good local control with low morbidity. Radiotherapy could enhance local control in advanced disease. Wait and see is an exploratory option for asymptomatic, stable, and nonprogressing AA in which surgery would be mutilating.
    International Journal of Gynecological Cancer 01/2013; 23(3). DOI:10.1097/IGC.0b013e3182843063 · 1.95 Impact Factor
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    ABSTRACT: To investigate and evaluate the clinical management strategies of aggressive angiomyxoma (AA) in female genital tract and pelvis. A cohort of 13 patients with AA diagnosed and treated in Peking Union Medical College Hospital in the last 12 years was reported focusing on the results of the managements and prognosis. The mean age at initial presentation was 36.9 years. The commonest site of tumor was perineum. Only two cases were accurately diagnosed as AA preoperatively by biopsy and fine needle aspiration of the tumors respectively. MRI helpfully reveals the location, relationship and degree of infiltration between tumors and pelvic organs. Surgery is the mainstay treatment. 11 of 12 patients had complete resection and majority of the operations were finished successfully through trans-perineum and trans-vagina approaches. Three cases with positive expression of ERs and PRs in the tumors received GnRHa injections which were useful preoperatively but not postoperatively. One repeatedly-recurrent case was treated with radiotherapy effectively. The recurrence rate in our study was 41.7% (5/12), with a median recurrence interval of 20.9 months. No patient developed distant metastases and died of the disease. AA preferentially involves the pelvic and perineal regions of women in reproductive age. Tumor biopsy and fine-needle aspiration cytology are conducive to the preoperative diagnosis. The individualized operative strategy and awareness to protect and rebuild structure and function of the organs should be emphasized during the management of AA. Long-term follow-up is mandatory because of the high rate of recurrence.
    European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 07/2013; 39(10). DOI:10.1016/j.ejso.2013.06.013 · 3.01 Impact Factor

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