Aggressive Angiomyxoma: Two Case Reports and Review of the Literature

Abstract

Aggressive Angiomyxoma (AA) is a kind of rare, low grade myofibroblastic neoplasm with high risk of local recurrence mainly for the character of locally aggressive and misdiagnosis as other soft tissue mass in the pelvis. The "laminated or swirled sign" of swirled strands of low-signal intensities in T2WI is the diagnostic sign for the layered configuration of AA. We report two cases with contrast enhanced CT and Dynamic Contrast Enhancement (DCE) MRI to show the characteristic imaging features and our findings about AA in enhanced CT and DCE MRI. KeywordsAggressive Angiomyxoma (AA), Laminated or Swirled Sign, Magnetic Resonance Imaging (MRI), X-ray Computed Tomography (X-ray CT), Multiplanner Reformation (MPR), Diffusion Weighted Imaging (DWI), Apparent Diffusion Coefficient (ADC) Case RepoRt Case OneA 29-year-old woman was incidentally found a mass in her vagina. She was asymptomatic and was diagnosed as fibroma by biopsy. The CTs can show a well-limited mass with low density compared to muscle located in the left pelvic cavity (Figure 1a). After iodine contrast injection, the mass showed a progressive and heterogeneous enhancement without any layered character (Figure 1b). MRI showed a big mass extending into the obturator foramen and ischiorectal fossa, displacing the gluteus, uterus and vagina without invading (Figure 2a). The mass showed ho-