Angiomyxolipoma shares cytogenetic changes with lipoma, spindle cell/pleomorphic lipoma and myxoma

Angiomyxolipoma of the right sub-brow: Case report with review of the literature

•

This case report of a rare benign tumor (Angiomyxolipoma) which is a subtype of lipoma.

•

Up to our knowledge this is the first case in Jordan and 20th in the world.

•

It is important to distinguish this lesion as a distinct from malignant subcutaneous lesions of fatty tissue.

•

Our case, being the oldest (78 year-old) ever reported.

•

Our case is the first to have facial location and myxoid content reacting to connective tissue mucin stain.

Introduction

Angiomyxolipoma (AML) is a rare variant of benign lipoma with characteristic histopathological and immuno-histochemical features. It consists of fatty tissue admixed with myxoid stroma and blood vessels. It was first described by Mai et al. in 1996 [1], with a total number of 19 cases reported since.

Presentation

This is the first report of an AML in subcutaneous tissue of the face, presenting as a 4-month old cystic lesion in a 78-year old lady. Diagnosis was based on radiological and histopathological with cytochemical findings.

Discussion

It is important to distinguish this lesion as distinct from malignant subcutaneous lesions of fatty tissue, especially with short history as seen in our case.

Conclusion

Precise diagnosis of angiomyxolipoma is important to avoid unnecessary investigations, stress and misdiagnosis of myxoid liposarcoma.

Renal Angiomyxolipoma: Its First Appearance!

Angiomyxolipoma is considered a very rare subtype of lipoma, with the latter being the most common type of mesenchymal neoplasm. Only 17 cases have been described in English medical literature. Angiomyxolipomas have been described in many locations, mostly in the subcutaneous tissue. In this report, we present the first case of renal angiomyxolipoma ever encountered. Diagnosis was made after many differential diagnoses had been ruled out. Subsequent management and follow-up are illustrated along with a discussion and review of literature.

A piezogenic papule with histopathologic features simulating angiomyxolipoma

Piezogenic papules are lesions that occur on the feet and wrists because of the herniation of fat through the dermis. These papules can be painful or completely asymptomatic. Poor compartmentalization of fat occurs because of thinner than normal fibrous trabeculae and contributes to the formation of piezogenic papules. On histological examination, fat is evident extending through the dermis. We report a case of a piezogenic papule simulating angiomyxolipoma on histological examination. The presented case suggests the possibility of an association between herniated fat tissue and mucin deposition with vascular proliferation.

Angiomyxolipoma (vascular myxolipoma) of the oral cavity. Report of a case and review of the literature

Angiomyxolipoma is a rare tumor characterized by a proliferation of adipose tissue associated with a myxoid stroma and multiple vascular channels. To date, ten cases of angiomyxolipoma located in subcutaneous tissue, spermatic cord and subungual area have been reported in the literature. We describe the clinical and histopathologic findings of the first case of intraoral angiomyxolipoma in a 12 year-old male, as well as the utility of immunohistochemistry as a useful tool in differential diagnosis of this particular lesion with respect to other benign and malignant lesions derived from adipose tissue.

Angiomyxolipoma (vascular myxolipoma) of subcutaneous tissue

Lipoma is the most common neoplasm of mesenchyme, and several subtypes have been described that vary according to their location and the presence of other tissue elements. Angiomyxolipoma is a very rare variant that consists of an admixture of adipose and myxoid elements with numerous vascular structures. It should be differentiated from other subtypes of benign and malignant lipomas. Here the case of a 69-year-old male is described who presented with a solitary asymptomatic mass on the left iliac crest. The histopathologic findings showed alternating nests of myxoid and adipose tissue containing dilated blood vessels, which was consistent with angiomyxolipoma.

Two cases of angiomyxolipoma (vascular myxolipoma) of subcutaneous tissue

Angiomyxolipoma (vascular myxolipoma) is a recently described rare variant of lipoma, four cases of which have been reported to date. Microscopically, the lesion consists of adipose tissue without lipoblasts, extensive myxoid areas, and numerous blood vessels. The main differential diagnosis of this lesion is myxoid liposarcoma, and other adipocytic lesions such as myxolipoma, myxoid spindle cell lipoma should be included. We report two cases of angiomyxolipoma located in the subcutaneous tissue of the forearm and the wrist.

Soft-tissue angiomatosis in adulthood: a case in the forearm showing a prominent myxoid adipose tissue component mimicking liposarcoma

Soft-tissue angiomatosis is a rare condition characterized by diffuse proliferation of benign vascular structures, accompanied by mature adipose tissue, which affect a large segment of the body in a contiguous fashion. Most patients present in childhood or adolescence. We report a case of large soft-tissue angiomatosis, located in the left forearm of a 65-year-old man, which showed extensive intramuscular and intermuscular infiltration, and embracement of the radius and the main vascular and neural bundles of the forearm. Due to the deep location, large size, ill-defined limits and non-homogeneous composition with areas suggestive of an adipose component in the radiological examination, the lesion raised the possibility clinically of a liposarcoma. The myxoid adipose tissue component of the lesion, a feature previously undescribed, and the predominance of small, capillary-sized vessels were considered concordant with the clinical diagnosis. This presentation is rare. The features of the lesion made complete surgical excision impossible and amputation of the extremity was considered the best treatment. The main differential diagnoses include infiltrating lipoma, myxolipoma, angiomyxolipoma, angiolipoma, intramuscular angioma, liposarcoma and low-grade myxofibrosarcoma. In conclusion, angiomatosis might simulate liposarcoma, particularly if the mass is large, heterogeneous, myxoid and appears later in life.

A novel t(X;2)(q13;q35) in clear cell sugar tumor of bone

Reciprocal translocations have been identified in a number of solid tumors and can serve as both diagnostic and prognostic indicators. When these translocations occur as the primary or sole chromosome aberration, they can potentially be associated with the formation of tumor-specific fusion genes at the translocation breakpoints. We present what is to our knowledge the first reported case of a primary clear cell sugar tumor of bone displaying a novel t(X;2)(q13;q35) as the sole cytogenetic aberration.

Angiomyxolipoma (Vascular Myxolipoma) of Subcutaneous Tissue

Three cases of angiomyxolipoma (vascular myxolipoma) have been published to date. We report an angiomyxolipoma located in the subcutaneous tissue of the scalp. Histologically, it consisted of an admixture of paucicellular myxoid areas and mature fat tissue, both containing numerous dilated blood vessels with hyalinized thin walls. The cells in the myxoid areas expressed CD34. This lesion requires differential diagnosis with other benign fat tissue tumors, especially myxoid spindle cell lipoma, superficial angiomyxoma, myxoid liposarcoma, and low-grade myxofibrosarcoma.

Clustering of deletions on chromosome 13 in benign and low-malignant lipomatous tumors

Deletions and structural rearrangements of the long arm of chromosome 13 are frequently observed in benign and low-malignant lipomatous tumors, but nothing is known about their molecular genetic consequences. We assessed the karyotypes of 40 new and 22 previously published cases (35 ordinary lipomas, 15 spindle cell/pleomorphic lipomas, 2 myxolipomas, 1 angiomyxolipoma and 9 atypical lipomatous tumors) with chromosome 13-abnormalities, and found bands 13q12-22 to be frequently affected. Twenty-seven cases with structural abnormalities within this region were selected for breakpoint and deletion mapping by metaphase fluorescence in situ hybridization (FISH), using a set of 20 probes. Deletions were found in 23 of 27 cases. The remaining 4 cases had seemingly balanced rearrangements. The breakpoints were scattered but clustered to band 13q14, and in all cases with unbalanced abnormalities, a limited region within band 13q14 was partially or completely deleted. A deletion within band 13q14 was found together with a breakpoint on the other homologue in 5 cases, 4 of which could be tested further with regard to the status of the retinoblastoma (RB1)-gene. In all 4 cases, only 1 copy of the gene was deleted. In addition to the breaks and deletions in the vicinity of the RB1-locus, several other regions of 13q were recurrently affected, e.g., in the vicinity of the hereditary breast cancer (BRCA2; 13q12)- and lipoma HMGIC fusion partner (LHFP; 13q13)- genes. Our findings strongly indicate that deletion of a limited region (approximately 2.5 Mbp) within 13q14, distal to the RB1-locus, is of importance in the development of a subset of lipomatous tumors.