Aggressive angiomyxoma of the pelvis and perineum
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Painless perineal swelling in a pregnant lady. No any past medical history.
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There is a well-defined pelvic mass with a laminated appearance and protruding and herniating into ischiorectal fossa and extending to perineal soft tissues on the left. The mass measures 9 x 5 x 3 cm with no evidence of invasion to adjacent structures. The lesion is isointense to muscle on T1WI and slightly hyperintense on T2WI and T2Fs. The mass shows swirled configuration.
Findings most suggestive of aggressive angiomyxoma.
Aggressive angiomyxomas are an uncommon mesenchymal tumor that predominantly affects the pelvis and perineum of young females. Aggressive angiomyxomas are benign tumors with a high rate of local recurrence. The layered configuration and swirled sign is the diagnostic sign of aggressive angiomyxomas.