Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and it...Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and its frequent association with local recurrence. Preoperative diagnosis and treatment may be difficult. We report a 55-year-old patient who presented with a pelvic mass with no significant medical history. The radiological assessment showed a pelvic cystic tumor retro and lateral bladder. A surgical excision was performed with a diagnosis of aggressive angiomyxoma pelvis that misdiagnosed as ovarian tumor. The patient received adjuvant radiotherapy after surgery and remains well with no signs of local recurrence at 12 months follow-up. As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery can not be overemphasized. The authors discuss this finding through the diagnostic difficulties and the evolution of this entity.展开更多
Background: Ischiorectal Fossa Tumors are rare and their management has not been protocolized. Patients: We retrospectively review four consecutive cases treated in our department, from January 2015 to July 2015. All ...Background: Ischiorectal Fossa Tumors are rare and their management has not been protocolized. Patients: We retrospectively review four consecutive cases treated in our department, from January 2015 to July 2015. All of them were discussed in a multidisciplinary team meeting. None of them were secondary to an inflammatory process. Results: A Magnetic Resonance Imaging was performed in all the four patients, and as it was not a malignant diagnosis made in any of them, we proceeded to resecate the lesions. None biopsies were performed and the benign diagnoses were confirmed by the pathologist. All the patients underwent a local posterior or perineal approach, because all the lesions (epidermoid cyst, hamartoma, lipoma and an aggressive angiomyxoma) were localized purely in the ischiorectal fossa, under the levator ani muscle and not invading any adjacent structures. In all of them, an R0 resection was performed. Conclusions: Ischiorectal fossa tumors are rare and there are few cases already published. Non-inflammatory lesions located in the ischiorectal fossa, with none invasion of rectum or levator ani muscle, are mainly benign lesions prone to their complete excision by a posterior approach. Biopsy is not always necessary unless there’s a suspicion of a malignancy or invasion of adjacent structures, and only in that case a biopsy should be made, because in some of them, a neo-adjuvant treatment can be useful to reduce the tumor and to perform an R0 resection.展开更多
文摘血管黏液瘤(angiomyxoma,AM)是一种近年来逐渐被认识的罕见的黏液背景上伴有血管增生的特殊类型软组织肿瘤,病理分为3型:浅表性、侵袭性、血管肌纤维母细胞瘤[1]。浅表性血管黏液瘤(superficial angiomyxoma,SA)常位于皮肤浅表部位,好发于躯干及下肢,偶见于生殖道,边界清楚,易复发,不具侵袭性。而侵袭性血管黏液瘤(aggressive angiomyxoma,AAM)好发于女性外阴、盆腔和会阴区,浸润深度较SA深,且边界不清晰,侵袭性强,世界卫生组织(World Health Organization)将其定义为'分化不明的肿瘤'[2]。
文摘Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and its frequent association with local recurrence. Preoperative diagnosis and treatment may be difficult. We report a 55-year-old patient who presented with a pelvic mass with no significant medical history. The radiological assessment showed a pelvic cystic tumor retro and lateral bladder. A surgical excision was performed with a diagnosis of aggressive angiomyxoma pelvis that misdiagnosed as ovarian tumor. The patient received adjuvant radiotherapy after surgery and remains well with no signs of local recurrence at 12 months follow-up. As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery can not be overemphasized. The authors discuss this finding through the diagnostic difficulties and the evolution of this entity.
文摘Background: Ischiorectal Fossa Tumors are rare and their management has not been protocolized. Patients: We retrospectively review four consecutive cases treated in our department, from January 2015 to July 2015. All of them were discussed in a multidisciplinary team meeting. None of them were secondary to an inflammatory process. Results: A Magnetic Resonance Imaging was performed in all the four patients, and as it was not a malignant diagnosis made in any of them, we proceeded to resecate the lesions. None biopsies were performed and the benign diagnoses were confirmed by the pathologist. All the patients underwent a local posterior or perineal approach, because all the lesions (epidermoid cyst, hamartoma, lipoma and an aggressive angiomyxoma) were localized purely in the ischiorectal fossa, under the levator ani muscle and not invading any adjacent structures. In all of them, an R0 resection was performed. Conclusions: Ischiorectal fossa tumors are rare and there are few cases already published. Non-inflammatory lesions located in the ischiorectal fossa, with none invasion of rectum or levator ani muscle, are mainly benign lesions prone to their complete excision by a posterior approach. Biopsy is not always necessary unless there’s a suspicion of a malignancy or invasion of adjacent structures, and only in that case a biopsy should be made, because in some of them, a neo-adjuvant treatment can be useful to reduce the tumor and to perform an R0 resection.
