Aggressive angiomyxoma in females: is radical resection the only option?

Background. Aggressive angiomyxoma is a rare mesenchymal tumor, characteriz ed by frequent local recurrences. Our aim is to assess the role of radical resection. Methods. Retrospective case review. The records of five patients with aggre ssive angiomyxoma during the period from 1984 to 1998 were reviewed and ana lyzed. A MEDLINE search from 1983 to May 1999 was performed. The clinical p resentation, surgical treatment, resection margin involvement and clinical outcomes were analyzed. Results. Together with our five cases, 106 cases have been reported in the world literature. The female-to-male ratio was 6.6:1. The age distribution was wide, with the peak incidence at 31 to 35. The local recurrence rate wa s high. Seventy-one percent of recurrence occurred within the first 3 years . Patients with clear resection margins have similar chances of remaining d isease-free compared with those having tumor-involved resection margins. Th en was no correlation between the size of the tumors and the chance of recu rrence. Conclusions. Though we aim for complete resection, incomplete or partial re section is acceptable, especially when high operative morbidity is anticipa ted and preservation of fertility is an issue. Long-term follow-up and care ful monitoring with imaging techniques are essential for timely identificat ion of recurrence and prompt resection.