Aggressive Angiomyxoma of the Lower Female Genital Tract in Pregnancy: A Review of the MITO Rare Tumors Group
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
3. Results
3.1. Etiopathogenesis
3.2. Clinical Features
3.3. Pathological Examination
3.4. Management
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Reference | Age (Years) | GA at Diagnosis (Weeks) | Location | Tumor Size (cm) | IHC | Treatment | Delivery (GA Weeks) | Recurrence | PFS (Months) |
---|---|---|---|---|---|---|---|---|---|
[15] | 37 | NA | Right vulva | 3 → 40 | NA | Pre-pregnancy LE | NA | Yes | NA |
[4] | 41 | 18 | Left labium minus | 6 × 6 × 4 | PR+++, ER+, S100− | LE at 18 weeks | VB (40) | NA | NA |
[16] | 32 | 32 | Vulva posterior commissura | 3 × 4 | ER+, PR− | LE 36 weeks | VB | No (9 months follow-up) | NA |
[17] | 36 | Present before and during the pregnancy, grew very rapidly after the birth. | Right major labium, pelvic-perineal region (between the obturator and levator muscles of the anus) | 6.5 ≥ 15 | Vimentin++ SM actin++ desmin++ ER++ PR++ S100− CD34− | LE postpartum + transperineal surgery (ischio-rectal fossa toilette + external sphincterotomy and reconstruction) (R0) | CS for breech presentation (40) | NA | NA |
[18] | 31 | NA (already present) | paravaginal/pararectal mass | NA | NA | Posterior exenteration (R1) and RT 60 Gy | NA | No recurrence after surgery (first suspected during 1st pregnancy) during second pregnancy 4 years later | 96 |
[18] | 34 | 30 | Left and right labia majora | NA | NA | left labial surgery (30 weeks GA; several weeks later, right labial mass surgery was performed); vulvectomy (R1) | NA | No | 24 |
[18] | 27 | Early pregnancy | Pelvis-perineum, in front of the bladder | NA | NA | Total exenteration (R1) | NA | No | 48 |
[5] | 25 | 12 | Right labia majus | 2 → 4 | Desmin+ ER+ PR− | LE 16 weeks | VB (40) | No | 9 |
[6] | 22 | Before pregnancy, recurrence at I trimester | Right vulva and pelvis | 8 (first diagnosis, before pregnancy) 3.1 × 1.9 × 2.2 (I trimester) → 5.1 × 4.6 × 3.5 (32 weeks), halved in size postpartum | NA | prenatal surgery (R1) + GnRH analogous + surgery + GnRH monitored in pregnancy | CS (38) (for mass) | Yes (in pregnancy) | NA |
[19] | 22 | Before pregnancy, recurred three times (last one during pregnancy) | Right vulva and vagina extending into right ichiorectal-fossa and levator ani | NA | NA | 3 LWE → successful pregnancy after third surgery (R1) + GnRH analogue | NA | Yes (before and during pregnancy) | 5 |
[20] | 43 | tumour gradually increased for 9 years, suddenly grew during and after pregnancy | Left labium majus | Up to 55 (postpartum) | ER+ | LE 9 months postpartum | CS (NA) | No | 8 |
[7] | 25 | 18 | Left labium majus | Up to 8 | NA | LE 18 weeks | VB (40) | No | 9 |
[21] | 24 | 16 | Right labium majus | Up to 30 | ER+ PR+ desmin+ | LE 20 weeks (R0) | CS for failed labor induction (40) | No | 60 |
[22] | 21 | 20 | Right labium majus | Up to 15 in pregnancy, up to 18 postpartum | NA | LE postpartum (6 weeks) (R0) | CS for vaginal mass (38) | No | NA |
[8] | 25 | 9 | Vaginal fornix | 12 | Vimentin+ SMA+ ER+ PR+ s100−, EMA−, CD34− | LE 13 weeks | VB (40) | No, after surgery (suspected REL in pregnancy) | |
[23] | 29 | 20 | Right labium majus | 2 → 7 | ER+ PR+ CD34+ | LE during CS (R1) | CS for vaginal mass (39) | No | 20 |
[24] | 24 | 17 | Vaginal fornix (bleeding, pain, vaginal mass) | 11.4 × 11.3 × 9.95 | ER+ vimentin+ PR− S100− | LE during abortion | Induced abortion | NA | NA |
[25] | 32 | 8 (2 months) | Right vulva | 3 → 5 (first pregnancy), up to 7 cm postpartum | Vimentin+++ ER++ PR++ desmin+ Ki-67 + (<1%) S100− | No treatment | VB (37) | Yes 40 months (during second pregnancy) | 8 |
LE 22 postpartum | |||||||||
6 × 4 × 3 (second pregnancy) | spontaneuos regression postpartum | CS for fetal distress (39) | 8 months after the second pregnancy, postpartum | ||||||
5.3 × 5.1 × 4.2 | LE 11 months postpartum +GnRH analogous | ||||||||
[26] | 36 | 20 | Prolapsed vaginal mass, vagina, vesico-vaginal space | 7 × 3 × 3.5 (enlarged in puerperium 7 × 7 × 7.5) | Vimentin+, Actin+/− CD34+/− S-100−, Desmin− ER+ PR+ EMA− Ki 67 < 1% | LE postpartum (R1) + GnRh analogues | CS for prolapsed mass (37) | NA | NA |
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Cicogna, S.; Dellino, M.; Miano, S.T.; Magazzino, F.; Domenici, L.; Pignata, S.; Mangili, G.; Cormio, G. Aggressive Angiomyxoma of the Lower Female Genital Tract in Pregnancy: A Review of the MITO Rare Tumors Group. Cancers 2023, 15, 3403. https://doi.org/10.3390/cancers15133403
Cicogna S, Dellino M, Miano ST, Magazzino F, Domenici L, Pignata S, Mangili G, Cormio G. Aggressive Angiomyxoma of the Lower Female Genital Tract in Pregnancy: A Review of the MITO Rare Tumors Group. Cancers. 2023; 15(13):3403. https://doi.org/10.3390/cancers15133403
Chicago/Turabian StyleCicogna, Stefania, Miriam Dellino, Salvatora Tindara Miano, Francescapaola Magazzino, Lavinia Domenici, Sandro Pignata, Giorgia Mangili, and Gennaro Cormio. 2023. "Aggressive Angiomyxoma of the Lower Female Genital Tract in Pregnancy: A Review of the MITO Rare Tumors Group" Cancers 15, no. 13: 3403. https://doi.org/10.3390/cancers15133403