Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2018; 6(14): 811-819
Published online Nov 26, 2018. doi: 10.12998/wjcc.v6.i14.811
Application of ultrasound in aggressive angiomyxoma: Eight case reports and review of literature
Chen-Yang Zhao, Na Su, Yu-Xin Jiang, Meng Yang
Chen-Yang Zhao, Na Su, Yu-Xin Jiang, Meng Yang, Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China
Author contributions: Zhao CY and Su N contributed equally to this work; Yang M, Su N and Zhao CY designed the study; Su N and Yang M provided the imaging data of the cases; Zhao CY, Su N and Yang M searched the literature and analyzed the data; Zhao CY wrote the paper; and Yang M, Su N and Jiang YX edited the paper.
Supported by the International S and T Cooperation Program of China, No. 2015DFA30440; the National Natural Science Foundation of China, No. 81301268; Beijing Nova Plan, No. xxjc201812 and No. Z131107000413063.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: This manuscript was prepared following the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Meng Yang, MD, Chief Doctor, Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, No. 1, Shuaifuyuan, Dongcheng District, Beijing 100730, China. yangmeng@pumch.cn
Telephone: +86-10-69155494 Fax: +86-10-69155494
Received: August 23, 2018
Peer-review started: August 23, 2018
First decision: October 4, 2018
Revised: October 16, 2018
Accepted: October 23, 2018
Article in press: October 22, 2018
Published online: November 26, 2018
ARTICLE HIGHLIGHTS
Case characteristics

A total of eight cases of aggressive angiomyxoma (AAM) who received imaging examinations and surgical resections are reported in the article.

Clinical diagnosis

AAM.

Differential diagnosis

Bartholin’s duct cyst, Gartner’s duct cyst, vaginal prolapse, angiomyofibroblastoma, myxoma, and myxoid sarcoma.

Laboratory diagnosis

There is no special laboratory diagnosis for the patients.

Imaging diagnosis

Ultrasound, computed tomography, and magnetic resonance imaging (MRI) can be utilized for the evaluation of AAM. The imaging features of AAM on ultrasound and MRI are characteristic.

Pathological diagnosis

Scattered spindle cells with low mitotic activity and a myxoid and collagen matrix are the main constituents of the lesions. Immunohistochemistry can also be helpful.

Treatment

The tumour of AAM requires a complete surgical resection. Gonadotropin releasing hormone agonist is also widely used.

Related reports

Approximately 300 cases of AAMs have been reported since the first report in 1983. This article is focused on the ultrasonic features of the neoplasms.

Term explanation

Dynamic contrast enhanced (DCE) imaging: DCE imaging is acquired after a rapid intravenous injection of gadolinium-DTPA. It can delineate the vasculature of local tissues and is helpful in evaluating vascularity. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC): DWI is an important sequence of MRI; it measures the mobility of water molecules due to Brownian motion. The ADC is a quantitative measure reflecting this motion. Contrast-enhanced ultrasound (CEUS): CEUS imaging is also obtained by injection of microbubbles, for better visualization of the anatomic structures and perfusion patterns.

Experiences and lessons

The ultrasonic features of AAM are distinguished. Ultrasound as a convenient imaging method, can play an important role in the diagnosis and follow-up of the disease.