{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:14Z","timestamp":1756425794452,"version":"3.44.0"},"reference-count":31,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,7,12]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>A multiparous woman presented with a large bulge protruding from the posterior wall of the vagina, initially diagnosed as a rectocele. Imaging revealed a cystic lesion measuring 9 cm \u00d7 6 cm \u00d7 3.5 cm suspected to be a developmental cyst. The lesion underwent surgical excision with significant improvement in symptoms. Histological analysis reported an aggressive angiomyxoma (AAM); postoperative hormonal therapies were considered and rigorous follow-up initiated. The authors discuss challenges in investigating and managing AAM with proposals made for improving preoperative diagnosis and optimising postoperative management. Correlating tumour size with symptoms, judicious planning of surgery, rigorous postoperative follow-up and involving the patient in all aspects of decision-making will guide clinicians in providing the best care in the rare entity of AAM.<\/jats:p>","DOI":"10.1136\/bcr-2025-266377","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T01:10:15Z","timestamp":1753665015000},"page":"e266377","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Unusual presentation of aggressive angiomyxoma arising from the posterior vaginal wall"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7027-0435","authenticated-orcid":false,"given":"Subanhey","family":"Thiyagalingam","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evangelia","family":"Mylona","sequence":"additional","affiliation":[{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7286-5968","authenticated-orcid":false,"given":"Wai","family":"Yoong","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, North Middlesex University Hospital NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,27]]},"reference":[{"key":"2025082801183400000_18.7.e266377.1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19960701)78:1<79::AID-CNCR13>3.0.CO;2-4"},{"key":"2025082801183400000_18.7.e266377.2","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-198307000-00009"},{"key":"2025082801183400000_18.7.e266377.3","unstructured":"Fletcher CDM , ed. Pathology and genetics of tumours of soft tissue and bone. Lyon: IARC Press, 2002:427."},{"key":"2025082801183400000_18.7.e266377.4","first-page":"966","article-title":"Characteristics and treatment strategies of aggressive angiomyxoma in women: A retrospective review of 87 cases","volume":"10","author":"Wang","year":"2023","journal-title":"Front Surg"},{"key":"2025082801183400000_18.7.e266377.5","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12051726","article-title":"Aggressive Angiomyxoma of the Vulva: Which Is the Best Management Strategy? Description of a Case Report and Review of Literature of the Last Ten Years","volume":"12","author":"Gulino","year":"2023","journal-title":"J Clin Med"},{"key":"2025082801183400000_18.7.e266377.6","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2011-0056-RS"},{"key":"2025082801183400000_18.7.e266377.7","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1053\/j.semdp.2020.09.003","article-title":"Mesenchymal lesions of the vulva","volume":"38","author":"Chapel","year":"2021","journal-title":"Semin Diagn Pathol"},{"key":"2025082801183400000_18.7.e266377.8","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2013-200880","article-title":"Uncommon perineal tumours: caution with aggressive surgical management","volume":"2013","author":"Duchalais","year":"2013","journal-title":"BMJ Case Rep"},{"key":"2025082801183400000_18.7.e266377.9","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.883805","article-title":"A Comprehensive Discussion in Vaginal Cancer Based on Mechanisms, Treatments, Risk Factors and Prevention","volume":"12","author":"Baral","year":"2022","journal-title":"Front Oncol"},{"key":"2025082801183400000_18.7.e266377.10","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.3390\/diagnostics12071563","article-title":"Gastrointestinal Stromal Tumors Mimicking Gynecologic Disease: Clinicopathological Analysis of 20 Cases","volume":"12","author":"Liu","year":"2022","journal-title":"Diagnostics (Basel)"},{"key":"2025082801183400000_18.7.e266377.11","first-page":"41","article-title":"Vaginal cysts: a common pathologic entity revisited","volume":"35","author":"Kondi-Pafiti","year":"2008","journal-title":"Clin Exp Obstet Gynecol"},{"key":"2025082801183400000_18.7.e266377.12","doi-asserted-by":"publisher","DOI":"10.1097\/00004347-198603000-00004"},{"key":"2025082801183400000_18.7.e266377.13","first-page":"125","article-title":"Vulvar lipoma: is it so rare?","volume":"45","author":"Odoi","year":"2011","journal-title":"Ghana Med J"},{"key":"2025082801183400000_18.7.e266377.14","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0412.2000.079003216.x"},{"key":"2025082801183400000_18.7.e266377.15","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912023412316"},{"key":"2025082801183400000_18.7.e266377.16","doi-asserted-by":"publisher","DOI":"10.1053\/S0046-8177(03)00419-2"},{"key":"2025082801183400000_18.7.e266377.17","first-page":"658","article-title":"Aggressive deep angiomyxoma--a case report and review of the literature","volume":"33","author":"Kasc\u00e1k","year":"2012","journal-title":"Eur J Gynaecol Oncol"},{"key":"2025082801183400000_18.7.e266377.18","doi-asserted-by":"publisher","DOI":"10.1053\/crad.2002.1127"},{"key":"2025082801183400000_18.7.e266377.19","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000031617","article-title":"Aggressive angiomyxoma of pelvis: A case report and literature review","volume":"101","author":"Lin","year":"2022","journal-title":"Medicine (Baltimore)"},{"key":"2025082801183400000_18.7.e266377.20","first-page":"610","article-title":"Aggressive angiomyxoma of the pelvis: a series of four cases and literature review","volume":"36","author":"Wu","year":"2015","journal-title":"Eur J Gynaecol Oncol"},{"key":"2025082801183400000_18.7.e266377.21","doi-asserted-by":"publisher","DOI":"10.1136\/ijgc-00009577-200501000-00021"},{"key":"2025082801183400000_18.7.e266377.22","first-page":"22","article-title":"Aggressive Angiomyxoma: An Ultrastructural Study of Four Cases","volume":"27","author":"Martinez","year":"2023","journal-title":"Ultrastruct Pathol"},{"key":"2025082801183400000_18.7.e266377.23","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.53.8.603"},{"key":"2025082801183400000_18.7.e266377.24","first-page":"580","article-title":"Cytogenic and molecular analysis of an aggressive angiomyxoma","volume":"147","author":"Kazmierczak","year":"1995","journal-title":"Am J Pathol"},{"key":"2025082801183400000_18.7.e266377.25","doi-asserted-by":"publisher","DOI":"10.1097\/PGP.0000000000000689"},{"key":"2025082801183400000_18.7.e266377.26","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2010.174"},{"key":"2025082801183400000_18.7.e266377.27","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-008-0561-3"},{"key":"2025082801183400000_18.7.e266377.28","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2018-0338"},{"key":"2025082801183400000_18.7.e266377.29","doi-asserted-by":"crossref","unstructured":"Xu H , Sun P , Xu R , et al . Aggressive angiomyxoma in pregnancy: a case report and literature review. J Int Med Res 2020;48. doi:10.1177\/0300060520936414","DOI":"10.1177\/0300060520936414"},{"key":"2025082801183400000_18.7.e266377.30","article-title":"Recurrent Aggressive Angiomyxoma That Responded to the Gonadotropin-Releasing Hormone (GnRH) Antagonist Relugolix","volume":"17","author":"Saito","year":"2025","journal-title":"Cureus"},{"key":"2025082801183400000_18.7.e266377.31","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0b013e3182a22019"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266377","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:18:45Z","timestamp":1756369125000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266377"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,27]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bcr-2025-266377"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266377","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}