IMMUNOHISTOCHEMICAL ANALYSIS OF HORMONE RECEPTORS AND PROLIFERATING CELL NUCLEAR ANTIGEN IN AGGRESSIVE ANGIOMYXOMA OF THE VULVA

OBJECTIVE: Aggressive angiomyxoma (AA) is a frequently misdiagnosed tu mor which tends to locally recur. The purpose of our case study and re view is to characterize this tumor by immunohistochemical analysis of its estrogen and progesterone status and its proliferating capacity by proliferating cell nuclear antigen (PCNA), as well as, note any recur rent sites of spread. METHOD: A 43 year old woman presented with a sus pected Bartholin's gland abscess. Physical examination was consistent with a mass in the left labium majus. Marsupialization of the mass fai led. Resection of this tumor revealed an AA with positive tumor margin s. Lost to follow up, the patient was located 6 months later. Examinat ion revealed a palpable mass in the ischiorectal fossa. Extended-left, radical hemivulvectomy revealed recurrent tumor. Estrogen and progest erone receptor status was weakly positive. PCNA stained with the same intensity as the fibroconnective, tissue background. CONCLUSION: We re port on a case of AA as well as examine the literature to review a tot al of 32 cases. We note that AA is often misdiagnosed and tends to rec ur in the ischiorectal and retroperitoneal spaces. By means of immunoh istochemical analysis, we conclude: the estrogen and progesterone rece ptor status was weakly positive, but could not be distinguished from t he background-fibroblastic tissue, PCNA correlates well in this tumor with its low mitotic index; however, further similar studies are neede d to characterize this tumor. This may aid in treatment.