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作家相片Chih-Hung Lin 林志鴻

Aggressive Angiomyxoma—Report of a Rare Male Buttock Lesion

已更新:2019年12月2日

作者:Hsieh, Frank MA, MBBChir, FRACS*; Chuang, Kai-Ti MD*; Wu, You-Ting MD+; Lin, Chih-Hung MD*


文章出處:Plastic and Reconstructive Surgery – Global Open: August 2018 - Volume 6 - Issue 8 - p e1879


摘要:

侵襲性血管瘤是一種於男性中非常罕見的良性腫瘤,自該腫瘤發現以來,報導的男性病例少於50例,大多數侵襲性血管瘤的好發於育齡婦女的生殖器、會陰和骨盆區域。

這次我們報告了一例患有會陰腫脹的男性大量(> 20厘米)侵襲性血管瘤的病例。在宏觀上,腫塊是呈高度血管和分葉狀的,與叢狀神經纖維瘤具有高度相似性。顯微鏡檢查顯示:此腫瘤細胞含有扁平、橢圓形和紡錘形細胞,以及不同口徑的血管,伴隨的基質是呈粘液原性的。免疫組織化學染色顯示:CD34、S100和局部性雌激素受體呈陽性染色;肌動蛋白,結蛋白和孕酮受體呈陰性染色。組織學和免疫組化特徵有利於侵襲性血管肌瘤的診斷。

儘管在男性人群中這種腫瘤的存在非常罕見,但在遇到慢性會陰部病變時,應在鑑別診斷中考慮侵襲性血管肌瘤。


Summary: Aggressive angiomyxoma is a very rare benign tumor for male population with fewer than 50 cases reported since the description of this tumor. Most documented cases of aggressive angiomyxomas were found in genital, perineal, and pelvic regions in women of child bearing age. We report a case of a massive (> 20 cm) aggressive angiomyxomas in a man who presented with perineal swellings. Macroscopically the mass was highly vascular and lobulated with high similarity to plexiform neurofibroma. Microscopic examination revealed a hypocellular tumor comprising bland oval and spindle-shaped cells along with vessels of varying calibre. The accompanying stroma was myxocollagenous. Immunohistochemical staining showed CD34 and focal estrogen receptors positivity and negative staining for S100, actin, desmin, and progesterone receptors. The histologic and immunohistochemical features favored the diagnosis of aggressive angiomyxoma. Despite the rarity of such tumor in the male population, aggressive angiomyxoma should be considered in the differential diagnosis when encountering chronic para-perineal lesions.



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