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首页> 外文期刊>European journal of gynaecological oncology >Pedunculated aggressive angiomyxoma arising from the vaginal suburethral area: case report and review of literature.
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Pedunculated aggressive angiomyxoma arising from the vaginal suburethral area: case report and review of literature.

机译：阴道尿道下区域带蒂的侵袭性血管平滑肌瘤：病例报告和文献复习。

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BACKGROUND: Aggressive angiomyxoma (AA) is an uncommon, slow growing, locally infiltrative but non-metastasizing, distinctive mesenchymal tumor that predominantly affects the pelvis and perineum of premenopausal women. The mainstay of treatment is local excision with tumor-free margins; however, recurrences are common and related to inadequate primary excision. CASE: A pedunculated 3-cm mass arising from the vaginal suburethral area in a 49-year-old premenopausal woman was resected around the base of its pedicle. Microscopic examination revealed numerous blood vessels of various sizes set in myxoid stroma with spindle shaped fibroblasts. Immunohistochemical staining was strongly diffusely positive for vimentin, desmin, estrogen receptor (ER) and progesterone receptor (PR), weakly focally positive for CD34, and negative for S-100 protein, actin and Ki-67. These findings are compatible with the diagnosis of AA. To date, six months after surgery, the patient is alive and without evidence of recurrence. CONCLUSIONS: AA is often clinically misdiagnosed and it is only the microscopic examination strengthened with immunohistochemical staining that definitely and undeniably contributes to the final diagnosis of AA. Based on this case report and on the previously reported five cases of pedunculated AA arising from the vulvovaginal region, including one tumor arising from the vaginal suburethral area, it seems that pedunculated AAs arising from the vulvovaginal region are at negligible risk of recurrence after local excision.
机译：背景：侵袭性血管粘液瘤（AA）是一种不常见，生长缓慢，局部浸润但无转移的独特间充质肿瘤，主要影响绝经前妇女的骨盆和会阴部。治疗的主要方法是局部切除，无肿瘤边缘。但是，复发很常见，并且与原发切除不足有关。病例：一名49岁绝经前妇女阴道下尿道带蒂带蒂的3厘米肿块被切除，其蒂根部周围。镜检发现粘液样基质中有纺锤形成纤维细胞的许多大小各异的血管。免疫组化染色显示波形蛋白，结蛋白，雌激素受体（ER）和孕激素受体（PR）呈强弥散阳性，CD34呈弱局灶性阳性，而S-100蛋白，肌动蛋白和Ki-67呈阴性。这些发现与AA的诊断是相容的。迄今为止，手术后六个月，病人还活着，没有复发的迹象。结论：AA经常在临床上被误诊，只有通过免疫组织化学染色加强的显微镜检查才能肯定且不可否认地有助于AA的最终诊断。根据该病例报告和先前报道的五例由外阴阴道区域引起的带蒂AA的病例，包括一个由阴道下尿道区域引起的肿瘤，看来由外阴阴道区域引起的带蒂AA的局部切除术后复发的风险可忽略不计。

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