Akhavan Setareh, Nikfar Somayeh, Behboudi Behnam, Malek Mahrooz, Saffar Hana, Zamani Narges
Department of Gynecologic Oncology, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Department of Obstetrics and Gynecology, Taleghani Hospital, Arak University of Medical Sciences, Arak, Iran.
Int J Surg Case Rep. 2021 Apr;81:105756. doi: 10.1016/j.ijscr.2021.105756. Epub 2021 Mar 14.
Aggressive angiomyxoma is characterized as a non-capsulated soft mass with the ability to progress to surrounding tissues but without metastasis to distant tissues. Slowing tumor extension leading delayed tumor diagnosis, expression of different types of hormonal receptors, therapeutic ineffectiveness of noninvasive treatment approaches and misdiagnosis have remained as the major challenges for managing this tumor.
Herein, we described a case of aggressive angiomyxoma located in the posterior of the uterus and vagina that as successfully managed surgically to remove tumor mass followed by gonadotropin-releasing hormone (GnRH) agonist to prevent tumor recurrence.
Surgical resection is the treatment of choice in aggressive angiomyxoma with complete success rate, however despite such successfulness, about two-thirds of patients experienced postoperative recurrence rate that could be prevented by hormone-based therapy especially GnRH agonist.
Aggressive angiomyxoma is a rare tumor with locally invasive behavior. As misdiagnosis is common imaging like MRI with DWI should be considered. The best treatment is surgical resection by experienced surgeons in tertiary referral hospitals. Even with complete resection, the recurrence rate is high. So adjuvant medical treatment seems to be necessary.
侵袭性血管黏液瘤的特征为无包膜的软组织肿块，能够向周围组织浸润生长，但不会发生远处转移。肿瘤生长缓慢导致诊断延迟、不同类型激素受体的表达、非侵入性治疗方法的治疗无效以及误诊，一直是管理这种肿瘤的主要挑战。
在此，我们描述了一例位于子宫和阴道后部的侵袭性血管黏液瘤病例，该病例通过手术成功切除肿瘤肿块，随后使用促性腺激素释放激素（GnRH）激动剂预防肿瘤复发。
手术切除是侵袭性血管黏液瘤的首选治疗方法，成功率较高，然而，尽管手术成功，但约三分之二的患者术后复发率较高，而基于激素的治疗，尤其是GnRH激动剂，可以预防复发。
侵袭性血管黏液瘤是一种具有局部侵袭行为的罕见肿瘤。由于误诊常见，应考虑采用如MRI联合弥散加权成像（DWI）等影像学检查。最佳治疗方法是由三级转诊医院经验丰富的外科医生进行手术切除。即使完全切除，复发率仍然很高。因此，辅助药物治疗似乎是必要的。
