Unusual location of aggressive angiomyxoma in a male

Aggressive angiomyxoma is a rare, benign neoplasm that usually occurs in the perineum of young women. It has a tendency to recur locally, possibly due to incomplete surgical excision in many cases. This may be related to failure to recognize the nature and extent of the tumour pre-operatively, inability to distinguish tumour from normal connective tissue intra-operatively and reluctance to risk significant surgical morbidity removing tumour that is intimately related to the urethra, vagina and rectum. It has a well-recognized imaging appearance. The tumour occasionally occurs in men, most frequently in the scrotum. Pelvic and retroperitoneal occurrence has been described however usually represents extension from the perineum or lower genital tract. We present a case of aggressive angiomyxoma enveloping the iliacus muscle in a 76-year-old man.