Incidentally detected perineal aggressive angiomyxoma in an asymptomatic patient with uterine leiomyomas

Abstract

This case report describes the incidental diagnosis of a rare perineal aggressive angiomyxoma in a 41-year-old woman undergoing magnetic resonance imaging for preoperative evaluation of uterine leiomyomas. Although the patient was largely asymptomatic apart from mild urinary incontinence, MRI revealed a large pelvic-perineal mass with characteristic imaging features, including a laminated appearance, finger-like extension into the perineum, high T2 signal intensity, and marked contrast enhancement, enabling a confident preoperative diagnosis. No evidence of metastatic disease was identified. The report highlights the distinctive radiological characteristics of aggressive angiomyxoma, emphasizes the importance of recognizing these imaging findings to facilitate accurate diagnosis, and underscores the need for complete surgical excision because of the tumor’s high risk of local recurrence despite its generally benign behavior.