Pararectal angiomyxoma: a diagnostic dilemma

Dalvi, Abhay; Garale, Mahadeo; Churiwala, Jayati J.; Landge, Avinash; Husain, Sakina; Rewatkar, Ajinkya

doi:10.1093/jscr/rjz331

Cited by 5 publications

(3 citation statements)

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“…Although rare, neurofibromas and perineal schwannomas can also be evoked. Submucosal or exophytic rectal tumors are among possible diagnoses, including gastrointestinal stromal tumors (GIST), neuroendocrine tumors (NET), leiomyomas, leiomyosarcomas, and hemangiomas [ 1 ]. Endometriomas, abscesses, and duplication cysts are also considered [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

En bloc resection of pararectal ectopic thyroid tissue: a case report

Charbonneau,

Lefebvre,

Bouchard

2023

Journal of Surgical Case Reports

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A pararectal mass’ specific diagnosis can be challenging as a broad range of both benign and malignant tumors are possible. Many of these lesions are congenital and do not require treatment, if asymptomatic. Special attention is to be paid when imaging findings are not typical. In such cases, definitive diagnostic can require surgical excision. To this day, ectopic thyroid tissue was not part of known differential diagnosis. This is the first reported case of thyroid adenoma found in the perirectal area. Ectopic thyroid gland can progress over time and include malignant transformation, although rare. It needs to be considered when managing these cases, especially in unusual locations. This case report offers a systematic approach to the atypical pararectal tumor. It shares new specific clinical experience in managing a case of pararectal ectopic thyroid adenoma, from both a surgical and a histopathological point of view.

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Section: Introductionmentioning

confidence: 99%

En bloc resection of pararectal ectopic thyroid tissue: a case report

Charbonneau,

Lefebvre,

Bouchard

2023

Journal of Surgical Case Reports

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“…Aggressive angiomyxomas (AAM) are rare mesenchymal neoplasms that tend to grow in the pelvis and perianal regions (1)(2)(3)(4)(5)(6)(7)(8)(9). They occur more frequently in premenopausal than postmenopausal women, with a peak incidence in the forties (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…However, metastasis to other distant sites in the body is rare, and the general prognosis is good (4). The mainstay of treatment is surgical excision, aiming to achieve optimal debulking, which has been performed via various approaches, such as a transperineal or pararectal incision, minimally invasive technique, or laparotomy (5)(6)(7)(8)(9)(10). For oncological surgeries, access to the tumour without excessive handling and resection of the mass with clear margins is essential to avoid adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

Single-port laparoscopic and transvaginal resection of a large pelvic aggressive angiomyxoma: a case report

Ng¹,

Wu²,

Nadarajah³

2022

AME Surg J

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Background: Aggressive angiomyxomas (AAM) are rare mesenchymal neoplasms that occur more commonly in women. The mainstay of treatment is surgical excision which can be performed via various approaches. However, there are limited reports on minimally invasive surgeries in the treatment of AAM.We report a successful case of single-port laparoscopic and transvaginal resection of a pelvic AAM.Case Description: Our patient was a 45-year-old female who presented with symptomatic anaemia from menorrhagia and a vaginal lump of one year's duration that was worsening and affecting her quality of life (QOL). There was a 20 cm prolapsed, reducible smooth mass from the vagina on examination. An magnetic resonance imaging (MRI) scan showed a 23.9 cm × 12.7 cm × 8.4 cm extraperitoneal, mildly enhancing soft tissue mass sited between the uterus, vagina anteriorly and the rectum posteriorly, with a significant prolapsed component which showed no overt infiltration or invasion into the adjacent structures or sacrococcygeal spine. She underwent a single-port laparoscopic total hysterectomy, bilateral salpingectomies, and resection of the retroperitoneal mass. Intra-operatively, the uterus was 12 weeks in size. There was a large retroperitoneal mass on the right side, of which 40 cm had prolapsed through the vagina. The mass extended to the right common iliac vessels and down to the Pouch of Douglas. It was adherent to the pelvic sidewall, ureters, and retroperitoneal space. There was no direct involvement of the uterus, bowels, or ureters. The patient recovered well postoperatively, and the histology of the mass was an AAM that was strongly positive for oestrogen and progesterone receptors. To date, the prognosis was good as the woman was well with no recurrence for two and a half years. She regained her QOL. She will need to continue her follow-up to assess the long-term prognosis.Conclusions: A minimally invasive approach is increasingly used in various oncological surgeries, especially gynaecology oncological cases. Our case demonstrates that a combination of single-port laparoscopic and transvaginal techniques can be performed with the benefits of complete enucleation and resection of the tumour, less scarring and lesser postoperative pain. This study provides a possible alternative surgical procedure for patients with AAM that experienced surgeons can perform safely.

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