Aggressive angiomyxoma of the pelvis with high Ki-67 expression: a case report and literature review

Purpose: As a benign tumor, aggressive angiomyxoma (AA) of the pelvis has a high local recurrence rate within several years after surgery. Radiation therapy has been proved to be ineffective for preventing recurrence. Ki-67 is a famous marker of cell proliferation for many cancers. High Ki-67 expression was correlated with radiosensitivity in other cancers. For aggressive angiomyxoma, Ki-67 expression and its relationship with radiosensitivity were rarely reported. Therefore, the authors present a case of AA with high Ki-67 expression. Materials and Methods: A 30-year-old woman presented with menorrhagia and a slowly growing mass on the right side of the pelvis. She was diagnosed with AA based on clinical features, radiological investigation, histopathology, and immunohistochemical stains. The tumor was excised successfully. Staining for Ki-67 was approximately 30% positive. After the excision, the patient was treated with a total dose of 48 Gy in 24 fractions using three-dimensional conformal radiation therapy. Results: The patient had local recurrent tumor at 16 months of follow-up after the surgery. Conclusion: AA of the pelvis has a high local recurrence rate within several years after surgery. Whether the recurrence was associated with high Ki-67 expression needs more clinical cases observations in the future.