A case of angioleiomyoma presenting as a pulsatile tumor in the left ring finger

Angioleiomyoma of the proper ulnar digital artery: Case report

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Angioleiomyoma is a rare benign tumor comprised of smooth muscle cells.

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Other than biopsy, no modality of investigation can conclude the diagnosis.

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Favorable prognosis can be obtained by simple local excision.

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This case report presents a condition in which this tumor emerged from hand’s artery - An extraordinary observation.

Introduction

With the rarity and benign nature, angioleiomyoma is a tumor of disputed etiology that originates from the tunica media of the blood vessels. Lacking any characteristic clinical or radiological features, often leading to preoperative misdiagnosis, it is only diagnosed confidently on the basis of histopathology; for this reason combined with the rarity, angioleiomyoma would not be usually found at the top of the differential diagnosis list. Local excision is usually curative with excellent prognosis.

Case

This report discusses a case of a 60-year-old healthy lady who complained of a chronic painless mass in the right 2nd digit. Originating from the proper ulnar digital artery, it was excised with no complications. Histopathology results confirmed the diagnosis of angioleiomyoma. No recurrence was observed 6 months following the procedure.

Discussion

Out of the handful published papers concerned with angioleiomyoma in hands, few report the origin to be the digital artery.

Conclusion

Further awareness about this tumor is required and it should be included in the differential diagnoses list of the treating surgeon.

A Rare Case of Angioleiomyoma of the Hand

Angioleiomyoma is a benign tumor of the vascular system that is often not considered in the differential diagnosis of a painless subcutaneous nodule of the body. In this report, we present a rare case of angioleiomyoma of the phalanx in the left hand in a middle aged man. He underwent surgical excision of the mass with no complications. Given the nonspecific and indolent presentation, our case had a broad differential diagnosis including ganglion cyst and histopathological examination was warranted for definite diagnosis. At 9-month follow-up, the patient was asymptomatic with no signs of recurrence. 

Angioleiomyoma of the superficial palmar arterial arch

Angioleiomyomas are benign solitary soft-tissue tumors that originate from the vascular smooth muscle of vessels and rarely occur in the hand. Pain and tenderness are the only clinical characteristics. This report presents a rare case of angioleiomyoma arising from both the superficial palmar arch and a concomitant vein of the artery. The MRI findings lack specific radiological features. However, three-dimensional magnetic resonance angiography demonstrated the existence of a relationship between the tumor and its feeding vessels. The diagnosis was made after a histopathological study of the tumor. Adequate collateral circulation should be confirmed both before and during surgery if the lesion occurs within an artery. Angioleiomyoma should therefore be included in the differential diagnosis of painful vascular tumors with no neurological findings in the hand.