Zhang Q, Yan HL, Lu Q, Luo Y. Value of contrast-enhanced ultrasound in deep angiomyxoma using a biplane transrectal probe: A case report. World J Gastroenterol 2023; 29(26): 4214-4221 [PMID: 37475848 DOI: 10.3748/wjg.v29.i26.4214]
Corresponding Author of This Article
Yan Luo, Doctor, Professor, Department of Medical Ultrasound, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. yanluo@scu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jul 14, 2023; 29(26): 4214-4221 Published online Jul 14, 2023. doi: 10.3748/wjg.v29.i26.4214
Value of contrast-enhanced ultrasound in deep angiomyxoma using a biplane transrectal probe: A case report
Qiong Zhang, Hua-Lin Yan, Qiang Lu, Yan Luo
Qiong Zhang, Hua-Lin Yan, Qiang Lu, Yan Luo, Department of Medical Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Zhang Q and Luo Y contributed to the study conceptualization; Luo Y and Lu Q supervised the study; Zhang Q and Yan HL contributed to data collection and manuscript drafting; Yan HL and Lu Q contributed to manuscript revision; and all authors have approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Luo, Doctor, Professor, Department of Medical Ultrasound, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu 610041, Sichuan Province, China. yanluo@scu.edu.cn
Received: March 2, 2023 Peer-review started: March 2, 2023 First decision: May 16, 2023 Revised: May 23, 2023 Accepted: June 13, 2023 Article in press: June 13, 2023 Published online: July 14, 2023 Processing time: 129 Days and 18.5 Hours
Abstract
BACKGROUND
Deep angiomyxoma (DAM) is a very rare tumor type. Magnetic resonance imaging (MRI) is considered the best imaging modality for diagnosing DAM. Computed tomography (CT) is used mainly to assess the invasion range of DAM. The value of ultrasonography in the diagnosis of DAM is still controversial. Through a literature review, we summarized the current state of ultrasonic examination for DAM and reported for the first time the contrast-enhanced ultrasound (CEUS) features of DAM seen using a biplane transrectal probe.
CASE SUMMARY
A 37-year-old woman presented with a sacrococcygeal mass that had gradually increased in size over the previous 6 mo. MRI and CT examinations failed to allow a definite diagnosis to be made. Transperineal core needle biopsy (CNB) guided by transrectal ultrasound and CEUS was suggested after a multidisciplinary discussion. Grayscale ultrasound of the lesion showed a layered appearance with alternating hyperechoic and hypoechoic patterns. Transrectal CEUS showed a laminated distribution of the contrast agent that was consistent with the layered appearance of the tumor on grayscale ultrasound. We performed transperineal CNB of the enhanced area inside the tumor under transrectal CEUS guidance and finally made a definitive diagnosis of DAM through histopathology. The patient underwent laparoscopic-assisted transabdominal surgery combined with transperineal surgery for large pelvic tumor resection and pelvic floor peritoneal reconstruction. No recurrence or metastasis was found at the nine-month follow-up.
CONCLUSION
Transrectal CEUS can show the layered perfusion characteristics of the contrast agent, guiding subsequent transperineal CNB of the enhanced area within the DAM.
Core Tip: Deep angiomyxoma (DAM) is a very rare tumor. Imaging examinations play an important role in the diagnosis of DAM. Magnetic resonance imaging is considered the best imaging modality for diagnosing DAM. Computed tomography is used mainly to assess the invasion range of DAM. The value of ultrasonography in the diagnosis of DAM is still controversial. We reported for the first time the contrast-enhanced ultrasound (CEUS) features of DAM seen using a biplane transrectal probe. Transrectal CEUS can provide more abundant diagnostic information in terms of the blood perfusion characteristics of DAM, guiding subsequent transperineal puncture of the enhanced area within the tumor.
