Immunohistochemical analysis of hormone receptors and proliferating cell nuclear antigen in aggressive angiomyxoma of the vulva.
OBJECTIVE
Aggressive angiomyxoma (AA) is a frequently misdiagnosed tumor which tends to locally recur. The purpose of our case study and review is to characterize this tumor by immunohistochemical analysis of its estrogen and progesterone status and its proliferating capacity by proliferating cell nuclear antigen (PCNA), as well as, note any recurrent sites of spread.


METHODS
A 43 year old woman presented with a suspected Bartholin's gland abscess. Physical examination was consistent with a mass in the left labium majus. Marsupialization of the mass failed. Resection of this tumor revealed an AA with positive tumor margins. Lost to follow up, the patient was located 6 months later. Examination revealed a palpable mass in the ischiorectal fossa. Extended-left, radical hemivulvectomy revealed recurrent tumor. Estrogen and progesterone receptor status was weakly positive. PCNA stained with the same intensity as the fibroconnective, tissue background.


CONCLUSIONS
We report on a case of AA as well as examine the literature to review a total of 32 cases. We note that AA is often misdiagnosed and tends to recur in the ischiorectal and retroperitoneal spaces. By means of immunohistochemical analysis, we conclude: the estrogen and progesterone receptor status was weakly positive, but could not be distinguished from the background-fibroblastic tissue, PCNA correlates well in this tumor with its low mitotic index; however, further similar studies are needed to characterize this tumor. This may aid in treatment.
Rotmensch
E J
EJ
Department of Obstetrics and Gynecology, Boston University School of Medicine, Massachusetts.
Kasznica
J
J
Hamid
M A
MA
D000328:Adult; D000951:Antigens, Neoplasm / Q000032:analysis*; D005260:Female; D006801:Humans; D009232:Myxoma / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D009364:Neoplasm Recurrence, Local; D009687:Nuclear Proteins / Q000032:analysis*; D018809:Proliferating Cell Nuclear Antigen; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D014846:Vulvar Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000601:surgery
D000951:Antigens, Neoplasm; D009687:Nuclear Proteins; D018809:Proliferating Cell Nuclear Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone