title: Selective marginal resections in the management of aggressive angiomyxomas.
abstract: OBJECTIVE
  Aggressive angiomyxomas (AA) are rare tumors, most commonly presenting in the pelvis of women of childbearing age. This study presents the results of selective marginal resection of this disease in patients managed at a single institution.
  
  
  METHODS
  Patients diagnosed with AA from July 2001 to July 2015 were identified from a prospectively maintained histopathology database.
  
  
  RESULTS
  Seventeen patients were diagnosed with AA in the study period. The median age at diagnosis was 48 years. Females were more commonly affected with a M:F of 1:8.5. The most common differential diagnoses were an ischiorectal abscess or Bartholin's cyst. Fifteen cases occurred in the pelvis, with two cases at other sites. Median maximum tumor diameter was 10 cm. Of the pelvic cases, 12 were managed operatively via perineal, abdominal, or abdominoperineal approaches. Excision was performed in a marginal fashion with minimal morbidity. Local recurrence developed in 58.3% with a median local recurrence free survival of 25 months. No patients developed metastatic disease or died from disease.
  
  
  CONCLUSIONS
  AA are rare tumors with a propensity for local recurrence. Atypical presentations of other perineal pathologies should prompt further investigation. Surgery should be reserved for symptomatic patients and is associated with low rates of morbidity. J. Surg. Oncol. 2016;114:828-832. © 2016 2016 Wiley Periodicals, Inc.
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Henry G
authors.initials: HG
authors.lastname: Smith
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Khin
authors.initials: K
authors.lastname: Thway
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Christina
authors.initials: C
authors.lastname: Messiou
authors.affiliation: The Gynaecology Unit, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Desmond P
authors.initials: DP
authors.lastname: Barton
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Thomas
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hayes
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom.
authors.forename: Dirk C
authors.initials: DC
authors.lastname: Strauss
authors.affiliation: The Sarcoma Unit, The Department of Academic Surgery, The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom. myles.smith@rmh.nhs.uk.
authors.forename: Myles J F
authors.initials: MJ
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D000072662:Margins of Excision; D008875:Middle Aged; D009232:Myxoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010386:Pelvic Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: aggressive angiomyxoma; soft-tissue sarcoma; surgical outcomes