Abstract
IntroductionAggressive angiomyxoma is a rare myxedematous mesenchymal tumor that mainly occurs in the female pelvis and perineum. The principle of treatment for aggressive angiomyxoma is surgical excision. The tumor can be removed by local excision alone when it occurs locally on the perineum. However, it cannot be completely excised by a perineal approach alone when it passes through the perineum and pelvic bone to extend into the retroperitoneal space.Case presentationA 34-year-old Asian woman presented with a rapidly growing left perineal mass and swelling in the left gluteal region. The swelling was associated with a mild, dull pain in the left gluteal region. In the present case of bulky aggressive angiomyxoma extending to the perineum and retroperitoneal space, the authors made an inverted Y incision through the buttock, removed the coccyx and lower portion of the sacrum, and excised the retroperitoneal mass and perineal lesion through a perineal approach.ConclusionThe inverted Y incision and trans-sacral approach can provide easy access to deep retroperitoneal aggressive angiomyxoma and reduce damage to neighboring organs.
Highlights
Aggressive angiomyxoma is a rare myxedematous mesenchymal tumor that mainly occurs in the female pelvis and perineum
The swelling was associated with a mild, dull pain in the left gluteal region
In the present case of bulky aggressive angiomyxoma extending to the perineum and retroperitoneal space, the authors made an inverted Y incision through the buttock, removed the coccyx and lower portion of the sacrum, and excised the retroperitoneal mass and perineal lesion through a perineal approach
Summary
Aggressive angiomyxoma (AAA) is a rare myxedematous mesenchymal tumor that mainly occurs in the female pelvis and perineum. The tumor can be removed by local excision alone when it occurs locally on the perineum It cannot be completely excised by a perineal approach alone when it passes through the perineum and pelvic bone to extend into the retroperitoneal space [2,3]. In 2003, Sonoda et al [13] used the trans-sacral approach to remove a remnant cervix in a 71year-old woman with endometrial cancer who had undergone previous laparotomy He suggested that if radical resection is needed in an unusual situation, adaptation of different surgical approaches may be required. The -described inverted Y incision and trans-sacral approach can provide easy access to deep retroperitoneal AAA and reduce damage to neighboring organs
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