A rare case of giant angiomyxoma in pelvicthat presented whit abdominal pain

Background: Angiomyxoma is a seldom encountered benignneoplasm of mesenchymal origin that predominantly manifestsin the pelvic and perineal regions. It is more prevalent amongfemales during their reproductive years.Case Presentation: Wereport the case of a ۴۰-year-old female patient who presentedwith chronic and progressive lower abdominal pain for the durationof one year. Ultrasonography revealed a large, solid massmeasuring approximately ۱۰ centimeters with indistinct differentiationfrom the uterus. An ultrasound-guided core biopsywas performed and pathological result revealed hypercellularfibrotic tissue with an increased number of small capillary vessels.The decision was made to proceed with resection via atransabdominal approach into the retroperitoneal space. A solidmass measuring approximately ۱۰ centimeters with a capsulewas identified anterior to the Levator ani muscles and was completelyexcised. Pathological result confirmed the diagnosis ofangiomyxoma.Discussion: Although angiomyxoma is benign, the tumor isstill aggressive because of the high rate of local recurrence afterresection. Angiomyxoma is a mesenchymal tumor, composedof fibroblasts within a myxoid background. Small sized bloodvessels showed a scattered distribution, but large vessels, seenfrequently in aggressive angiomyxoma, were absent. Moreover,no plexiform capillary pattern was evident.Conclusion: Although angiomyxoma is a rare disease, itshould be considered in the differential diagnosis of pelvicretroperitoneal masses, particularly in women of reproductiveage. Thorough radiological and physical examinations can aidin suspecting the disease, but histological examination remainsthe gold standard for diagnosis. The primary treatment for angiomyxomais complete surgical excision of the mass along withits capsule.