Incidental para-ureteral aggressive angiomyxoma: a rare case report and literature review
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CASE REPORT
Incidental para‑ureteral aggressive angiomyxoma: a rare case report and literature review Ming Liu1†, Ting‑Shuai Zhai2†, Xiao‑Feng Zhao1, Li‑Jin Feng3, Xin‑Sheng Lyu4, Lan‑Ting Hu1, Zheng‑Xin Wang1, Wei‑Guo Ma1, Jian Zhang2, Xiao Chen1, Bin‑Jie Su1, Xu‑Dong Yao2, Jing‑Yi Lu1 and Lin Ye1,2*
Abstract Background: Aggressive angiomyxoma (AA) is a rare tumor that typically occurs in the pelvis and perineum, most commonly in women of reproductive age. However, no para-ureteral AA has been reported according to the literature. Case presentation We herein describe the first case of para-ureteral AA. A 62-year-old male presented to our institute in March 2017 with a para-ureteral mass that was 15 mm in diameter incidentally. No symptom was observed and laboratory analysis was unremarkable. Magnetic resonance and computed tomography imaging showed a non-enhancing mass abutting the left ureter without causing obstruction. Laparoscopic resection of the mass was performed without injury to the ureter. Pathologic and immunohistochemical results were consistent with AA. Till now, no recurrence was noticed. Conclusions: We reported a rare case of para-ureteral AA, along with a literature review. Early diagnosis, proper surgi‑ cal plan and long-term close follow-up is recommended for its high risk of recurrence and malignant potential. Keywords: Angiomyxoma, Ureter, Case management Background Aggressive angiomyxoma (AA), synonymously referred to deep angiomyxoma (DAM), is a very rare mesenchymal tumor characterized by local aggressiveness and high risk of recurrence [1]. AA preferentially grows in pelvis and perineum of females aged 30 to 60, with a femaleto-male ratio approximately 6:1 [2]. In 1983 Steeper and Rosai first described this disease and named it “aggressive angiomyxoma” [3]. According to the latest WHO classification AA was classified as “tumors of uncertain
differentiation”. Pre-operative diagnosis is difficult due to its rarity and lack of typical presenting signs and symptoms. Wide surgical excision is the curative and foremost treatment method for AA [4]. Local recurrence is common even after complete excision. So long-term close follow-up is recommended [5]. However, no para-ureteral AA has been reported. A case of para-ureteral AA of a 62-year-old male is presented herein. To the best of our knowledge, this is the first reported case of para-ureteral AA.
*Correspondence: [email protected] † Ming Liu and Ting-Shuai Zhai have contributed equally to this work 2 Department of Urology, Shanghai Tenth People’s Hospital, Tongji University School of Medicine, No.301, Middle Yan‑Chang Rd., Jing‑An District, Shanghai 200072, China Full list of author information is available at the end of the article
Case presentation A 62-year-old male was hospitalized in March 2017 with a para-ureteral mass that was 15 mm in diameter found through a routine check-up incidentally. There was no symptom. On physical examination no abnormality was
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