Residente de Ginecología y Obstetricia, Universidad Surcolombiana, Neiva (Colombia).
Médico general, Hospital Universitario Hernando Moncaleano Perdomo, Neiva (Colombia).
Rev Colomb Obstet Ginecol. 2020 Dec;71(4):384-394. doi: 10.18597/rcog.3527.
To present the case of a patient diagnosed with aggressive angiomyxoma of the vagina and to conduct a review of the diagnosis, treatment and prognosis of this disease condition.
A 46-year old female patient complaining of dysuria and vaginal mass sensation. Physical exploration and imaging studies revealed a tumor extending into the pelvic cavity. The mass was resected through a vaginal approach and pathology of the surgical specimen showed an aggressive angiomyxoma of the vagina. New retrorectar surgery was performed three months after the initial resection because of recurrence. A search was conducted in the Medline via PubMed, Lilacs, Scielo and Google Scholar databases using the terms "Angiomyxoma," "Aggressive" and "Vagina." The search included review articles, case reports and case series published in English and Spanish since 1995. The information extracted included diagnosis, symptoms, signs, immunohistochemistry and imaging studies used, type of treatment surgical or other - and prognosis. Findings are described in narrative form.
Overall, 23 titles were identified, of which 14 case reports, 2 clinical case series and 1 review article met the inclusion criteria. Sixty-five per cent of the patients were between 30 and 50 years of age. Diagnosis was made by immunohistochemistry in 8 cases, and diagnostic imaging was used in 12 cases. Computed tomography showed sharper contours of the lesions. Surgical treatment was applied in all reports, supplemented by hormonal therapy in 4 cases. There was follow-up in 14 of the 17 cases reported.
Aggressive angiomyxoma of the vagina is rare. Assessment of the role of various immunohistochemical tests is needed in cases identified as aggressive angiomyxoma on histopathology. Evaluation of hormonal treatment as an adjunct to surgery is required. Prognosis is good.
介绍一名被诊断为阴道侵袭性血管黏液瘤的患者病例，并对该疾病的诊断、治疗和预后进行综述。
一名 46 岁女性患者因尿痛和阴道肿块感就诊。体格检查和影像学研究显示肿瘤延伸至盆腔。该肿块通过阴道途径切除，手术标本的病理检查显示为阴道侵袭性血管黏液瘤。由于复发，在初次切除后三个月进行了新的直肠后手术。通过 Medline 中的 PubMed、Lilacs、Scielo 和 Google Scholar 数据库，使用“Angiomyxoma”、“Aggressive”和“Vagina”等术语进行了搜索。搜索包括自 1995 年以来发表的英文和西班牙文的综述文章、病例报告和病例系列。提取的信息包括诊断、症状、体征、免疫组织化学和影像学研究、手术或其他治疗类型以及预后。结果以叙述形式描述。
共确定了 23 个标题，其中 14 个病例报告、2 个临床病例系列和 1 个综述文章符合纳入标准。65%的患者年龄在 30 至 50 岁之间。8 例通过免疫组织化学诊断，12 例通过诊断性影像学检查。计算机断层扫描显示病变轮廓更清晰。所有报告均采用手术治疗，4 例辅以激素治疗。17 例报告中有 14 例有随访。
阴道侵袭性血管黏液瘤罕见。在组织病理学上被诊断为侵袭性血管黏液瘤的病例中，需要评估各种免疫组织化学试验的作用。需要评估激素治疗作为手术辅助的作用。预后良好。
