Two Patients with Aggressive Angiomyxoma of the Pelvis who Received Neoadjuvant Hormone Therapy

Abstract

Two patients with aggressive angiomyxoma (AAM) of the pelvis received preoperative neoadjuvant hormone therapy. Patient 1 was a 46-year-old woman with a double-headed tumor. The inferior pole reached the right wall of the vagina and invaded the pelvis. The longest diameter of the tumor was 10 cm. AAM was diagnosed by transperineal needle biopsy. The patient received preoperative hormone therapy with a gonadotropin-releasing hormone agonist and tamoxifen, following which the longest tumor diameter decreased to 6.8 cm. Patient 2 was a 43-year-old woman with a tumor that extended from the subcutaneous tissue of the right buttock to the right dorsal side of the uterus in the pelvis. The tumor was 17.3 cm in its longest diameter. The patient received tamoxifen monotherapy, following which the longest diameter of the tumor decreased to 14.7 cm. The tumors in both patients could be resected with no macroscopic evidence of residual tumor, although in Patient 2, histopathological examination revealed a positive resection margin. AAM commonly arises at sites that are anatomically difficult to access, and we believe that preoperative hormone therapy is a useful treatment strategy for reducing the tumor size.