Sarcopedia

IntermediateSoft tissue

Angiomyxoma

Synonyms: Aggressive angiomyxoma

Unique to the soft tissues of the lower genital tract, pelvis and perineum

Quick Facts

Behaviour

Intermediate

Category

Soft tissue

Synonyms

Aggressive angiomyxoma

Category

Soft tissue

Behaviour

Intermediate

Gender

Female (5:1)

Tissue of Origin

Uncertain

Epidemiology

  • Unique to the soft tissues of the lower genital tract, pelvis and perineum
  • Age range: 14 - 77 years (median ~ 40 years)

Clinical Features

  • Ill defined, painless, slowly enlarging mass
  • Symptoms of pelvic fullness or frequent urination
  • Can clinically resemble a Bartholin cyst, Gartner duct cyst, lipoma or hernia
  • May grow rapidly in pregnancy

Location

  • Vulva
  • Perineum
  • Deep pelvic tissues
  • Retroperitoneum
  • Penis

Imaging

USS: local infiltration and rich vasculature

Pathology

Hypocellular lesion with myxoid stroma and abundant vasculature, infiltrating fibroadipose tissue

Treatment

Wide local excision with clear margins

Prognosis

  • Positive margins increase recurrence risk
  • Approximately 30% local recurrence
  • Distant metastasis is exceptionally rare

Key Points

  • Unique to the soft tissues of the lower genital tract, pelvis and perineum
  • Local recurrence in ~ 30% but distant metastasis and death from disease are exceptionally rare
  • Clinical follow-up recommended

Workup - Blood Tests

No blood tests required

Workup - Local Imaging

MRI with contrast of primary site

Workup - Biopsy

Core needle biopsy or excisional biopsy

Workup - Staging

CT chest - metastasis rare but should be excluded at staging

Workup - Other

MDT review with sarcoma specialist centre

Follow-up Summary

  1. Soft Tissue Tumours - Localised Extremity - Low Grade

    Routine MRI of primary site not indicated unless difficult to assess clinically

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