CLINICAL CASES   

Minerva Urologica e Nefrologica 2000 June;52(2):77-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: Italian

Superficial angiomyxoma of epididymis. A clinicopathologic study of a new case

Vella R., Calleri D.

Azienda Ospedaliera S. Giovanni Battista - Torino Divisione Universitaria di Patologia Urologica (Direttore: Prof. A. Tizzani)

Angiomyxomas are distinctive soft tissue tumors associated with a high risk of local recurrence but lack of metastatic potential. These tumors occur nearly exclusively in the soft tissues of the pelvis and perineum of adult women. Three types have been identified: aggressive angiomyxoma, angiomyofibroblastoma and superficial angiomyxoma. Histologically, aggressive angiomyxoma is characterized by a proliferation of spindle- or stellate-shaped cells widely separated by loose myxoid stroma in which a prominent vascular component is dispersed. Angiomyofibroblastoma shares many histological features with aggressive angiomyxoma; however, the presence of a sharply circumscribed border, and plump epithelioid tumour cells arranged in a predominantly perivascular distribution usually allow distinction from aggressive angiomyxoma. Superficial angio-myxoma can be distinguished from aggressive angiomyxoma and angiomyofibroblastoma by the multinodular growth, abundant stromal mucin, low cellularity, and lack of perivascular accentuation of stromal cells. The case of a 50-year-old-man with superficial angiomyxoma of epididymis mimicking a testicular tumor is presented. Local excision was performed. On gross inspection, this lesion was a soft bulky mass, with gelatinous appearance and not infiltrating adjacent structures. Cytologic examination of this material revealed hypocellular smears and a background of watery myxoid material. The nuclei revealed a bland chromatin pattern. This lesion was characterized by an abundant vascular component with large, thick-walled vessels. Immunohistochemically, the neoplastic cells were not positive for alpha-smooth muscle actin and desmin. The conclusion is drawn that according to a tendency of these tumors to recur locally, treatment should consist of wide surgical excision, as complete as technically possible.