Obstet Gynecol Sci.  2018 Nov;61(6):693-697. 10.5468/ogs.2018.61.6.693.

Robotic extralevator excision of a retrorectal giant aggressive angiomyxoma

• Kelley SR

• KMID: 2426014
• DOI: http://doi.org/10.5468/ogs.2018.61.6.693

Abstract

Aggressive angiomyxoma (AA) is a very rare mesenchymal tumor most commonly found in the pelvic and perineal regions. For the complete excision of retrorectal tumors, with extension through the levator muscle into the ischioanal space, open anterior and posterior approaches are typically required. Herein, we report our experience with robotic excision of a giant presacral AA with extralevator extension into the ischioanal space and extraction via Pfannenstiel incision, which we found to be technically feasible, efficacious, and safe to perform. Mayo Clinic Institutional Review Board exemption status was obtained for this study.

Keyword

Robotics; Region-Sacral; Angiomyxoma

MeSH Terms

Ethics Committees, Research
Myxoma*
Robotics

Figure

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  Fig. 1 (A) Pelvic magnetic resonance imaging with arrow noting retrorectal aggressive angiomyxoma. (B) Pelvic magnetic resonance imaging with arrow noting retrorectal aggressive angiomyxoma extending into the ischioanal space.

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  Fig. 2 Gross pathologic specimen with arrows noting the levator muscle with ischioanal fat inferiorly.

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  Fig. 3 (A) Microscopic low-powered histology showing monotonous and hypocellular cells composed of small spindled and stellate fibroblasts. (B) Microscopic medium-powered histology showing myxoid stroma with collagen fibers and a prominent dilated thick-walled vessel. (C) Microscopic high-powered histology showing myxoid stroma with spindled and stellate fibroblasts and no atypia.

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