Preoperative Arterial Embolization Facilitating Safe Resection of a Hypervascular Aggressive Angiomyxoma: A Case Report

Figures

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  FIGURE 1. Magnetic resonance imaging of the pelvis. (A–C) T2‐weighted images showing a 12‐cm tumor with mixed high and low signal intensities and a characteristic swirling appearance (white arrow). The tumor showed a low signal intensity on T1‐weighted images. (D, E) High signal intensity on diffusion‐weighted images of the tumor and heterogeneous enhancement after contrast administration (white arrows).

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  FIGURE 2. Angiographic findings. (A) Angiography showing that the tumor (yellow arrow) was supplied by the inferior gluteal artery (black arrow) and internal pudendal artery (white arrow). (B) After arterial embolization using detachable coils, angiography showed near‐complete disappearance of tumor blood flow from these feeding arteries.

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  FIGURE 3. Gross appearance of the resected specimen. The tumor was soft with a smooth surface, and the cut surface was gelatinous.

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  FIGURE 4. Histopathological findings of the tumor. (A) The tumor consisted of spindle‐shaped cells with mild atypia embedded in a myxoid stroma containing abundant blood vessels (H&E). Scale bar = 100 μm. (B) The tumor cells were positive for smooth muscle actin (SMA), desmin, and estrogen receptor (ER) and negative for CD34. Scale bar = 100 μm.