Aggressive Angiomyxoma: Two Case Reports and Review of the Literature

Abstract

A 29-year-old woman was incidentally found a mass in her vagina. She was asymptomatic and was diagnosed as fibroma by biopsy. The CTs can show a well-limited mass with low density compared to muscle located in the left pelvic cavity (Figure 1a). After iodine contrast injection, the mass showed a progressive and heterogeneous enhancement without any layered character (Figure 1b). MRI showed a big mass extending into the obturator foramen and ischiorectal fossa, displacing the gluteus, uterus and vagina without invading (Figure 2a). The mass showed homogeneous isointensity compared to muscleonT1WI and hyteroseneous hyperintensity with some whirled strands of low signal on T2WI (Figure 2b). After Gd-DTPA injection, the mass showed a progressive enhancement and laminated strands of hyper-intensity (Figure 2c). The surgery of wide local excision was performed. Histopathology showed spindle tumor cells with no nuclear atypia scattered in the stroma of vascular and loose myxoid. The cytoplasm was positive for desmin and smooth muscle actin. The pathological result was aggressive angiomyxoma.