Deep (Aggressive) Angiomyxoma
Elizabeth A. Montgomery, MD
Key Facts
Clinical Issues
Deep soft tissues of vulvovaginal region
Typically in women in reproductive age group
Benign, but recurrences common
Macroscopic Features
Poorly circumscribed gelatinous mass
Most examples > 10 cm
Microscopic Pathology
Infiltrative growth pattern
Small bland ovoid and spindled cells
Abundant myxoid stroma
No mitotic activity
Numerous vessels with sizes ranging from capillaries to thick-walled larger vessels
Perivascular lesional cells radiate from around vessels
 This is the typical loose myxoid hypocellular appearance of aggressive angiomyxoma. The vessels have somewhat thick walls  , and overall cellularity is low. |
 A characteristic feature of aggressive angiomyxoma is the appearance of lesional cells spinning off a vessel that they encircle. This example has mildly atypical nuclei but is devoid of mitoses. |
TERMINOLOGY
Synonyms
Aggressive angiomyxoma of female pelvis and perineum
Also known to arise in men
Definitions
Hypocellular myxoid neoplasm with prominent vessels, typically of deep pelvic tissues
Can be locally aggressive but does not metastasize
CLINICAL ISSUES
Presentation
Deep soft tissue mass in genital region
Vulvovaginal (women)
Typicall in women of reproductive age
Inguinoscrotal (men)
Treatment
Surgical excision
Reports of responses to gonadotrophin-releasing hormone agonists and antiestrogens
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