Primary medical management of recurrent aggressive angiomyxoma of the vulva with a gonadotropin-releasing hormone agonist

Background. An aggressive angiomyxoma of the pelvis is a locally infiltrative lesion treated with wide local excision. Recurrence is common. A potential medical treatment alternative is reported. Case. A 34-year-old woman presented with her second recurrence of a vulvar angiomyxoma following two prior surgical excisions. Analysis of the recurrent tumor for estrogen and progesterone receptors was strongly positive. The patient was treated with 3 months of a gonadotropin-releasing hormone (GnRH) agonist. Comparison of pre- and posttreatment magnetic resonance imaging scans showed complete radiographic resolution of the tumor. Physical examination confirmed these findings. Conclusion. Medical management with a GnRH agonist may obviate the need for radical exenterative surgery for a recurrent aggressive angiomyxoma of the vulva.