Background: Aggressive angiomyxoma is a benign, rare, and locally aggressive neoplasm that can be found in the perineal or pelvic region of female patients of the reproductive age group. Case: We present the first case report in Australia of a vaginal aggressive angiomyxoma in an obstetric patient during her 24th week of pregnancy. Results: The patient underwent surgical excision and close follow-up with no evidence of tumor recurrence in 2 years. Conclusion: Aggressive angiomyxoma is associated with a high rate of local recurrence and the recommended approach is preoperative imaging, surgery, and close follow-up. ( J GYNECOL SURG 36:151
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