Hormonal treatment of aggressive angiomyxoma

Purpose

This review aims to evaluate the efficacy of hormonal therapy, including gonadotropin-releasing hormone agonists (GnRH agonists), aromatase inhibitors (AIs), selective estrogen receptor modulators (SERMs) and combination therapy in the management of aggressive angiomyxoma (AAM).

Methods

A comprehensive literature search was conducted to identify studies reporting the use of hormonal interventions in AAM treatment. Seventy-five scientific papers were analyzed to gather data on treatment modalities, response rates, and adverse effects, which were then extracted and synthesized. The review was structured according to the PICO(S/T) framework to ensure consistency in data synthesis and interpretation. This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure methodological transparency and rigor.

Results

Gonadotropin-releasing hormone agonists demonstrated anti-tumoral activity by inducing hypoestrogenism, resulting in tumor shrinkage and prevention of recurrence. Aromatase inhibitors stabilized disease progression and improved symptoms. Selective estrogen receptor modulators administered postoperatively prolonged progression-free survival. Combination therapies exhibited synergistic effects, with notable responses observed in neoadjuvant and adjuvant settings.

Conclusions

Hormonal therapy presents an effective adjunct to surgical resection in AAM management, especially in cases demonstrating estrogen receptor (ER) and progesterone receptor (PR) positivity. While effective, careful monitoring for adverse effects and individualized treatment approaches are necessary to optimize outcomes and minimize risks. This review highlights the evolving role of hormonal interventions in the multidisciplinary management of AAM, emphasizing the need for further research to refine treatment strategies and improve patient outcomes.