Maxillary aggressive angiomyxoma showing ineffective to radiotherapy: a rare case report and review of literature

Abstract

Aggressive angiomyxoma, mostly originating in the female pelvis and peritoneum or in the male analogous sites, is a rare mesenchymal neoplasm characterized with infiltrative growth to adjacent tissue and local recurrence after primary excision. Herein, we report a case of aggressive angiomyxoma of maxilla in a 60-year-old male patient for its rarity. The patient presented with a one-year history of progressively enlarging maxillary mass on left side. Before referred to our hospital, he was given a biopsy and diagnosed as aggressive angiomyxoma by immunohistochemical staining. After that, he underwent 60 Gy radiotherapy. Unfortunately, CT scan showed bigger mass infiltrated to adjacent facial soft tissues and bones compared with that of before radiotherapy. Besides that, he began to suffer with ingravescent headache. The mass was surgically removed and the diagnosis was confirmed by immunohistology in our hospital. As a case of aggressive angiomyxoma occurred in a rare site and experienced an ongoing growth in spite of radiotherapy, its characteristics was discussed with a brief literature review, which may aid further understanding of aggressive angiomyoma.

Keywords: Maxillary neoplasm; aggressive angiomyoma; radiotherapy; treatment.

Figure 1

CT scans showing: A. maxillary hypodense mass with obscure border. B. increased mass volume with extensive infiltration to adjacent tissues after radiotherapy. Note the involved nasal septum and the lost tissue spaces.

Figure 2

Microscopic findings and immunohistochemical staining. A. Histological examinations stained with hematoxylin and eosin revealed scattered spindle and satellite shaped fibroblastic cells set in myxoid matrix with prominent vascularity, × 200. B. Immunohistochemical staining showed that tumor cells was positive for vimentin, × 200. C. Immunohistochemical staining showed that tumor cells was positive for smooth muscle actin, × 200. D. Immunohistochemical staining showed that tumor cells was negative for S-100, × 200. Preoperative clinical view of lesion of the oral floor and sublingual region.