Abstract
Aggressive angiomyxoma is a rare mesenchymal neoplasm, occurring mainly in females. It is located in the pelvis and perineum, with known metastasis and hormone sensitivity only in females. Local recurrence is relatively common. We describe the case of a 62-year-old man who presented with symptoms and signs of a spermatocele. Scrotal exploration with surgical excision of the lesion was done. Because a benign setting was assumed, no radical inguinal orchiectomy was performed. The specimen sent to pathology confirmed an aggressive angiomyxoma with positive resection margins. Despite the plurality of benign scrotal masses such as spermatoceles or hydroceles, rare neoplasms should always be kept in mind. Hence, complete excision should be performed whenever possible. We selected an active surveillance strategy despite positive margins, since there is no described case of metastasis in men to date. Therefore, regular scrotal ultrasound examinations every 3 months were arranged as follow-up.
Highlights
ConclusionDespite the plurality of benign scrotal masses such as spermatoceles or hydroceles, rare neoplasms should always be kept in mind
Aggressive angiomyxoma (AAM) is a rare mesenchymal neoplasm, occurring in the pelvis and perineum mostly in females [1, 2]
Aggressive angiomyxomas are mesenchymal neoplasms mainly in females arising from the soft tissues in the pelvis and perineum
Summary
The etiology and pathophysiology of AAM are poorly understood. The literature suggests slightly different presentations with metastasis only described in females. It is important to realize that cystic lesions in the scrotum do not include only hydroceles or spermatoceles. A high index of suspicion should be maintained during scrotal exploration, demanding. Complete excisions should be done whenever possible, to attain tumor-free resection margins during primary resection.
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