ABSTRACT
Aggressive angiomyxoma is a locally invasive, rarely diagnosed mesenchymal tumor that predominantly affects the perineal region of women in their reproductive years. It is typically found in areas such as the vagina, vulva, and other pelvic soft tissues, but its presentation can be highly variable. We describe a particularly unique case of aggressive angiomyxoma, presenting in an atypical manner within the vaginal region of a 31-year-old virgin woman. This case is noteworthy for the unusual growth pattern of the angiomyxoma-located strictly within the vaginal epithelium, showing no signs of invasion into surrounding tissues, which is not typical of the aggressive nature of this type of tumor. The patient presented with a mass that protruded through the hymen, an uncommon presentation that led to initial speculation about the nature of the mass. The definitive diagnosis of aggressive angiomyxoma was made by meticulous histopathological examination after surgical excision of the mass. This case emphasizes the critical importance of considering aggressive angiomyxoma in the differential diagnosis of vaginal masses, particularly those that do not exhibit invasive characteristics. The case also highlights the need for increased awareness among clinicians about the potential for atypical presentations of this rare tumor, to facilitate timely and accurate diagnosis, and to guide appropriate management strategies. This report contributes to the growing body of literature on aggressive angiomyxoma, highlighting the variability in its presentation and the need to heighten suspicion in atypical cases.
ABSTRACT
BACKGROUND: The clinical relevance of androgen receptors (ARs) expressed in breast cancer cells and the suggested prognostic impact has been an area of active research. The prevalence rate of AR expression in breast cancer has never been reported among Jordanian patients. OBJECTIVE: Determine the expression rate of ARs among invasive ductal breast cancer cases of different stages and molecular subtypes. Also, analyze the relationship between AR expression and clinicopathologic and immunohistochemical criteria, and assess the impact of AR expression on survival. DESIGN: Retrospective medical record review. SETTING: Tertiary care hospital in Amman, Jordan. PATIENTS AND METHODS: Our study comprised only of cases of invasive ductal breast carcinoma of no special type among females from records during a 10-year period between 2006 and 2015. Immunohistochemical staining was considered positive if more than 10% of tumor nuclei showed positive staining. MAIN OUTCOME MEASURES: The expression rate of ARs and the association of the expression rate with the clinicopathologic features of invasive breast cancer. SAMPLE SIZE: 293. RESULTS: Immunohistochemical staining for AR revealed positive stain.ing in 180 (61.4%) cases, including approximately 50% of triple-negative breast cancer cases. AR positivity correlated with estrogen receptor (ER) status (P=.007) and smaller T size (P=.014). However, no significant association was found with any of the other variables. AR expression was positively associated with overall survival (P=.022) in general and in ER-positive cases (P=.012). However, in the multivariate Cox regression model, AR was not independently associated with survival. CONCLUSIONS: These results were consistent with international reports showing a significant relationship of AR expression with ER status. In addition, AR expression was significantly associated with smaller tumor size. Although AR status was not independently associated with survival, our data suggest AR is a good prognostic factor. LIMITATIONS: Some clinical data were missing. CONFLICT OF INTEREST: None.
