(P 222) SURGICAL RESECTION OF ABDOMINOPELVIC AGGRESSIVE ANGIOMYXOMA: A RETROSPECTIVE REVIEW OF 12 CONSECUTIVE CASES

Objective: Aggressive angiomyxoma (AAM) is a rare mesenchymal tumor mostly arises from the pelvic and perineal soft tissues. Few studies reported its characteristics and outcome previously due to its rarity and challenge to treat. This study aimed to investigate the surgical outcome of patients with abdominopelvic AAM.

Methods: Medical records of patients who were admitted to surgery with pathological confirm of AAM in Peking University International Hospital from January 2016 through December 2021 were retrospectively retrieved from our retroperitoneal tumor database. Demographics, operative outcome and pathological findings were collected. Postoperative complications were evaluated through Clavien-Dindo classification grade system.

Results: A total of 12 consecutive patients (male/female 4:8) were included in this study. Median age was 45 years old. The clinical presentation varied among individuals, consisting of 2 abdominal discomforts, 4 constipations, 1 lumbago, 1 prolonged menstruation, and 1 buttock swelling. Other 3 cases were asymptomatic and found occasionally from abdominopelvic CT scans. R0/R1 resection was achieved in 100% of patients. Surgical approaches were defined and categorized per location of the tumor, including 7 abdominal approaches(AA), 3 sacrococcygeal perineal approaches(SPA), as well as 2 abdomino-sacral approaches(ASA). The mean operative time was 260.8±108.2min. Median intraoperative blood loss was 500ml (IQR 250,1400ml).
Postoperatively, 50% of patients developed various complications including 3 recto-vaginal-perineal fistulas and 3 wound infections. There was no operative mortality. Histopathology of all patients was suggestive of aggressive angiomyxomas. Immunohistochemistry was done with a 91.7% positive rate for estrogen and progesterone receptors.

Conclusion: The clinical manifestations of abdominopelvic AAM are mostly atypical. Surgical resection with curative intents remains the mainstay treatment of this disease, which was strongly suggested in experienced sarcoma centers due to high probabilities of severe postoperative complications.

Table 1 Clinical characteristics and operative outcome in all 12 patients.docx