A case of aggressive angiomyxoma. Differential diagnosis of abandoned non-organ organ tumors (literature review with their own clinical observations)

Background. Aggressive angiomyxoma is a rare pelvic-perineal tumor that affects mainly women aged 30-50 years. It can simulate a bartholine cyst, abscess, lipoma, simple labial cyst or other soft tissue tumors of the pelvis. The main features of angiomyxoma are asymptomatic course and absence of metastasis with a tendency to deep invasion and relapses after a surgical treatment. Clinical Case Description. The article describes a clinical case of aggressive angiomyxoma in a 33-year-old patient who was admitted to the emergency hospital with a suspected right sciatic hernia. According to the results of clinical and radiological examination, the formation of a presacral space was detected spreading to the m. levator ani on the right and into the tissue of the right ischiorectal fossa, infiltrating them. The specific features could not be identified at the initial stage of the diagnosis using the formal signs distinctive for the specific type of neoplasms. The diagnosis was made as a result of the morphological analysis of the surgical resection material of the tumor. The relapse was not detected in the following 6 months. Assuming the high risk of angiomixoma progression, the dynamic monitoring was continued. Conclusion. This study and the literature data have demonstrated the typical difficulties of the differential diagnosis and prognosis of the disease, the need for a comprehensive approach using multiparametric magnetic resonance imaging, both at the initial stages of examination and when monitoring the effectiveness of treatment.