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Gkegkes ID, Milionis V, Goutas N, Stamatiadis AP. Perianal Angioleiomyoma: A Case Report and Review of the Literature. J Med Ultrasound 2024; 32:179-182. [PMID: 38882621 PMCID: PMC11175385 DOI: 10.4103/jmu.jmu_107_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/28/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2024] Open
Abstract
Angioleiomyomas are rare benign tumors, which take origin from smooth muscle fibers of the tunica media of veins. Even though angioleiomyomas can appear anywhere in the body, these masses are rarely occurred in the gastrointestinal system. This is the first reported case of perianal angioleiomyomas, where the tumor in close relation with the anal canal was investigated with endoanal ultrasonography. Local excision of such lesion is generally curative.
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Affiliation(s)
- Ioannis D Gkegkes
- Department of Colorectal Surgery, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
- Athens Colorectal Laboratory, Athens, Greece
| | | | - Nikolaos Goutas
- Laboratory of Forensic Medicine and Toxicology, The National and Kapodistrian University of Athens, Athens, Greece
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Matsuda K, Hirao M, Noguchi T, Okamura G, Hoshida Y, Etani Y, Ebina K, Okada S, Hiraoka K, Hashimoto J. Angioleiomyoma mimicking a swollen bursa on first metatarsophalangeal joint accompanying with hallux valgus deformity. Mod Rheumatol Case Rep 2023; 8:210-214. [PMID: 37542432 DOI: 10.1093/mrcr/rxad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/03/2023] [Accepted: 07/30/2023] [Indexed: 08/07/2023]
Abstract
We present a case of a patient who underwent a modified scarf osteotomy and tumour excision based on a preoperative diagnosis of hallux valgus deformity and accompanying bursitis. Subsequent histopathological examination revealed that the tumour was an angioleiomyoma. While tumours around the first metatarsophalangeal (MTP) joint are typically associated with gouty nodules, infections, or swollen bursa (bursitis) in patients with hallux valgus deformity, the occurrence of soft tissue tumours in this area is rare. Moreover, angioleiomyoma is an even rarer form of soft tissue tumour and is seldom suspected prior to resection. To our knowledge, there have been no reports of angioleiomyoma arising in the first MTP joint. However, it is important to consider the possibility of an atypical tumour in cases where soft tissue masses are present, even in patients with hallux valgus deformity, and to perform at least imaging tests such as ultrasound and magnetic resonance imaging before surgery. This prospect should always be kept in mind.
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Affiliation(s)
- Kotaro Matsuda
- Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, Kawachinagano City, Osaka, Japan
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Makoto Hirao
- Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, Kawachinagano City, Osaka, Japan
| | - Takaaki Noguchi
- Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, Kawachinagano City, Osaka, Japan
| | - Gensuke Okamura
- Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, Kawachinagano City, Osaka, Japan
| | - Yoshihiko Hoshida
- Department of Pathology, National Hospital Organization, Osaka Minami Medical Center, Kawachinagano City, Osaka, Japan
| | - Yuki Etani
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Kosuke Ebina
- Department of Musculoskeletal Regenerative Medicine, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Seiji Okada
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita City, Osaka, Japan
| | - Koji Hiraoka
- Department of Orthopedic Surgery, Kurume University School of Medicine, Kurume City, Fukuoka, Japan
| | - Jun Hashimoto
- Department of Orthopaedic Surgery, National Hospital Organization, Osaka Minami Medical Center, Kawachinagano City, Osaka, Japan
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Dege T, Wobser M, Goebeler M, Reichel A. [Pressure sensitive livid node on the left knee]. Hautarzt 2021; 72:1116-1118. [PMID: 33942153 DOI: 10.1007/s00105-021-04827-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Tassilo Dege
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
| | - Marion Wobser
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - Matthias Goebeler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - Alexandra Reichel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
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Abstract
UNLABELLED Leiomyoma is a benign soft-tissue tumor that can arise in any soft tissue; however, in the extremities, it is usually a subcutaneous mass. Masses in the foot and ankle in general are rare, and few reports in the literature describe leiomyoma in this region of the body. We present a series of 8 cases of leiomyoma of the foot and ankle, 4 of which are subclassified as angioleiomyomas. The characteristic patient presentation, imaging, and histological findings are presented here to increase awareness of this soft-tissue mass in the foot and ankle. LEVELS OF EVIDENCE Level V.
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Affiliation(s)
- Lauren K Szolomayer
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut (LKS, WFC, DML).,University of Michigan Health System, South Main Orthopaedics, Ann Arbor, Michigan (PGT)
| | - Paul G Talusan
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut (LKS, WFC, DML).,University of Michigan Health System, South Main Orthopaedics, Ann Arbor, Michigan (PGT)
| | - Wayne F Chan
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut (LKS, WFC, DML).,University of Michigan Health System, South Main Orthopaedics, Ann Arbor, Michigan (PGT)
| | - Dieter M Lindskog
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut (LKS, WFC, DML).,University of Michigan Health System, South Main Orthopaedics, Ann Arbor, Michigan (PGT)
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Clinical experience with treatment of angioleiomyoma. Arch Plast Surg 2014; 41:374-8. [PMID: 25075360 PMCID: PMC4113697 DOI: 10.5999/aps.2014.41.4.374] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/03/2013] [Accepted: 12/17/2013] [Indexed: 11/25/2022] Open
Abstract
Background Angioleiomyoma, a vascular leiomyoma, is a rare, benign smooth-muscle tumor that originates in the tunica media of vessels. It occurs anywhere in the body, most frequently in the lower extremities. Methods We reviewed the medical records of 16 patients who were treated for angioleiomyoma between 2000 and 2012. The clinical features of angioleiomyoma and the correlation between symptoms and pathological subtypes were investigated. Results There were 9 males and 6 females. Ages of the patients ranged from 21 to 61. Pain was the primary symptom in 44% of the patients. Tumors were smaller than 2.0 cm in all dimensions and were located in the face in 4 patients, whereas 5 lesions occurred in the upper extremities and the remaining 7 in the lower extremities. Three histologic subtypes were identified: solid, venous, and cavernous. The subtypes did not correlate with the clinical symptoms. Conclusions Angioleiomyoma appears to be a rare tumor that occurs in the face and the extremities. The tumor usually occurs in middle age. A differential diagnosis of this tumor is difficult, but the tumor should be considered in the diagnosis of painful subcutaneous masses. Ultrasonography and magnetic resonance imaging can be helpful in the diagnosis of angioleiomyoma. These tumors can be successfully treated with simple excision, with a low recurrence rate.
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Raval A, Schulder M, Al-Atassi S. Neurosurgical management of a painful subcutaneous nodule of the knee: angioleiomyoma. Neurosurgery 2014; 75:E190-4; discussion E194. [PMID: 24867202 DOI: 10.1227/neu.0000000000000400] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND IMPORTANCE Angioleiomyoma (ALM) is a rare, benign smooth muscle tumor that can occur anywhere in the body. Diagnosis is usually delayed due to the unfamiliar location and presentation of the lesion. This tumor is not frequently discussed in neurosurgical publications as part of the differential diagnosis of painful subcutaneous lesions. To our knowledge, this is the first report of a neurosurgical presentation of ALM within an extremity. CLINICAL PRESENTATION A 42-year-old woman presented with more than 2 years of severe right knee pain. The patient had undergone several treatments, including a knee arthroscopy, all without significant relief. Magnetic resonance imaging performed with a fiducial marker placed directly on the point of tenderness demonstrated an 8-mm subcutaneous nodule. The patient underwent complete excision of the lesion, guided by the placement of the fiducial marker and its correlation with the preoperative magnetic resonance imaging. Intraoperatively, the lesion was not found to be associated with a nerve; however, there was a small vessel adjacent to the lesion. Pathology demonstrated this lesion to be an ALM. The patient's symptoms had completely resolved without any new neurological parasthesias or deficits on follow-up. CONCLUSION Neurosurgeons should keep ALM in the differential diagnosis of painful extremity lesions. Localization using a fiducial marker directly overlying the area of suspicion is useful for the neurosurgeon and also for the radiologist so that the lesion may not be overlooked. Unnecessary interventions for the patient may be avoided with appropriate diagnosis, and surgical resection provides complete cure of the symptoms.
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Affiliation(s)
- Ami Raval
- *Department of Neurosurgery, Cushing Neuroscience Institute, North Shore University Hospital, Manhasset, New York; ‡Department of Anatomic Pathology, North Shore University Hospital, Lake Success, New York
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Hamoui M, Largey A, Ali M, Fauré P, Roche O, Hebrard W, Canovas F. Angioleiomyoma in the ankle mimicking tarsal tunnel syndrome: a case report and review of the literature. J Foot Ankle Surg 2010; 49:398.e9-15. [PMID: 20605483 DOI: 10.1053/j.jfas.2010.04.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Indexed: 02/03/2023]
Abstract
We present the case of a 64-year-old woman with a subcutaneous vascular leiomyoma in the tarsal tunnel in the ankle. The patient presented with pain of several years' duration in the medial aspect of the ankle in the retromalleolar region corresponding to the tarsal tunnel and associated with a subcutaneous mass. We report the clinical manifestation, the imaging and histopathologic features, and a review of the literature. Vascular leiomyomas are part of the differential diagnosis of painful subcutaneous masses in the lower extremity.
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Affiliation(s)
- Mazen Hamoui
- Orthopaedic & Traumatologic Surgery Department III, Centre Hospitalier Universitaire, Hopital Lapeyronie, Montpellier, France.
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Abstract
Angioleiomyoma is a benign tumour arising from the vascular smooth muscle (tunica media) and presents commonly between third and fifth decades of life. Although there are sporadic reports about this tumour in the literature, none describes all the information in detail. This review is an attempt to collate all the facts in one concise article. Angioleiomyoma presents as a painful mass in approximately 60% of the cases. One of the distinct clinical feature noted is the increase in size of the swelling with physical activity of the involved part, especially in the hand. It should be considered in the differential diagnosis of painful nodular lesions of the extremity. Pre-operative diagnosis is difficult, but with a high index of suspicion and awareness, it is possible. The use of ultrasound and magnetic resonance imaging should be considered. It causes minimal morbidity and excision is usually curative. Histological examination using smooth muscle Actin stain portraits the smooth muscle bundles clearly.
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Affiliation(s)
- P Ramesh
- Broomfield Hospital, Chelmsford, UK.
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