Radiologic imaging findings of pelvic aggressive angiomyxoma correlated with surgical and pathological features

Mehmet Cingoz,Aylin Acar,Ali Kilic,Direnc Ozlem Aksoy,Eda Cingoz,İlkay Tosun

doi:10.1186/s43055-021-00642-7

Abstract

BackgroundAggressive angiomyxoma is an infrequent benign tumor that usually occurs in the pelvic region. Pelvic masses have variety of differential diagnosis but some featured findings should prompt the diagnosis of aggressive angiomyxoma by the radiologist.Case presentationA 40-year-old female patient presented with a two-year history of perineal swelling. Radiological examination including gray scale and color Doppler ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) was consistent with the diagnosis of aggressive angiomyxoma. The patient underwent surgical operation that ensures total resection of the tumor.ConclusionIn the case of extensive pelvic soft tissue mass with characteristic imaging findings, the radiologists should take the diagnosis of aggressive angiomyxoma into consideration.

Highlights

Aggressive angiomyxoma is a rarely encountered benign mesenchymal tumor that occurs predominantly in the pelvic and perineal area, with a strong female predominance in premenopausal age group [1]
Contrast enhanced computed tomography (128 slice GE Optima CT660 CT scanner (USA)) of the patient revealed the well-defined mass occupied a large intraabdominal volume located between L2 vertebra level and perineal region, causing anterior displacement of bladder and uterus
It is not possible to estimate the exact incidence of aggressive angiomyxoma among the other intra-abdominal mesenchymal tumors given its rarity [13]

Summary

Introduction

Aggressive angiomyxoma is a rarely encountered benign mesenchymal tumor that occurs predominantly in the pelvic and perineal area, with a strong female predominance in premenopausal age group [1]. 350 cases have been reported in the literature and due to its rarity, prevalence in the population is unknown [2, 3] Despite its name, it represents a benign tumoral lesion and the term “aggressive” emphasizes the often infiltrative nature of the tumor and its frequent association with local recurrence [2, 4]. The huge pelvic component of an aggressive angiomyxoma deep in relation to the pelvic diaphragm is not appreciated on clinical examination and can frequently be mistaken for Bartholin cyst, lipoma, rectocele or perineal hernia until radiologic evaluation [6]. Contrast enhanced computed tomography (128 slice GE Optima CT660 CT scanner (USA)) of the patient revealed the well-defined mass occupied a large intraabdominal volume located between L2 vertebra level and perineal region, causing anterior displacement of bladder and uterus.

Discussion

Conclusions