侵袭性血管黏液瘤12例临床分析及文献复习

Aggressive angiomyxoma:clinical analysis of 12 cases with literature review

目的探讨侵袭性血管黏液瘤(aggressive angiomyxoma,AAM)临床、病理特点、诊治方法及预后。方法回顾性分析2006年12月至2013年3月中国医科大学附属盛京医院收治的12例AAM的临床资料,对其临床、病理特点、诊断治疗方法及预后进行分析。结果患者年龄26～53岁(平均38.75岁);12例AAM患者多无明显症状,主诉多以发现包块逐渐增大(外阴、盆腔及臀部8例),其次为体检发现包块(3例,其中2例后期出现下腹坠痛),1例为尿频。增强CT及增强MRI可见特异性的"旋涡状"或"分层"结构;病理切片可见形态基本一致的星芒状、卵圆形或短梭形的瘤细胞,基质可见大量黏液,亦可见扩张的薄壁或厚壁血管。12例均行手术治疗,随访7例,无复发,失访5例。结论 AAM虽然属于良性肿瘤,但术后复发率高,需严密随访。治疗上以手术为主,亦可行考虑促性腺激素释放激动剂(GnRH-a)治疗。

Objective To investigate the clinical and pathology characteristics, diagnosis and treatment of Aggressive An- giomyxoma（AAM）. Methods A retrospective study was made of 12 patients with AAM, who were hospitalized at Shengjing Hospital Affiliated to China Medical University between 2006 and 2013. Those patients＇ clinical and pathology characteristics, diagnosis and treatments are analyzed respectively. Results The patients ranged between 26 and 53 （aver- age 38.75）. The patients with no obvious symptoms, firstly found masses gradually increases （ vulva, pelvic cavity and buttocks 8 cases）, secondly inspection found masses（3cases,icluding 2 cases had lower abdominal pain at the end）, fre- quent micturition lcase. Enhanced CT and MRI can find ＂swirled＂ or ＂layered＂ specific structure. Stellate, oval or spin- dle-shaped tumor cells and matrix showed large amounts of mucus, dilated thin or thick wall vessel could be seen in the pathological section. All patients accept ed surgery, following up 7 cases, relapse-free, lost to follow-up 5 cases. Con- clusion Although AAM were benign, AAM have a high recurrence rate after surgery, which should closely foll0w-up. The main treatment of AAM is surgery, GnRH-a can also be considered.