Angioleiomyoma in the posterior knee: A case report and literature review

Angioleiomyoma of the extremities: correlation of magnetic resonance imaging with histopathological findings in 25 cases

OBJECTIVE

To identify the characteristic magnetic resonance imaging (MRI) findings in angioleiomyoma and to clarify its relationship with histopathological findings.

MATERIALS AND METHODS

We retrospectively analyzed the MRI findings and pathological subtypes in 25 patients with subcutaneous angioleiomyoma of the extremities. Based on the previous reports, MRI findings that could be characteristic of angioleiomyoma were extracted. According to the World Health Organization classification, all cases were classified into three pathological subtypes: solid, venous, and cavernous. The relationship between MRI findings and pathological subtypes was analyzed.

RESULTS

The pathological subtypes were solid (n = 10), venous (n = 11), and cavernous (n = 4). The following MRI findings were observed: (a) hypo- or iso-intense linear and/or branching structures on a T2-weighted image (positive total/solid/venous/cavernous: 19/5/10/4, respectively), which we defined as "dark reticular sign"; (b) peripheral hypointense rim on a T2-weighted image (positive total/solid/venous/cavernous: 19/7/8/4, respectively); and (c) presence of any adjacent vascular structures (positive total/solid/venous/cavernous: 6/3/3/0, respectively). Chi-square test showed a significant relationship between dark reticular sign and pathological subtypes (p = 0.0426). The dark reticular sign was found more frequently in the venous and cavernous types than in the solid type. The other MRI findings did not reveal a significant relationship between pathological subtypes.

CONCLUSION

We present the largest case series exploring MRI findings in angioleiomyoma. The dark reticular sign was a characteristic MRI finding of angioleiomyoma and was seen in most of the venous and cavernous types, which may facilitate preoperative diagnosis.

Lateral Femoral Cutaneous Nerve Angiomyoma

Angiomyomas are benign tumors derived from smooth muscle cells of vessels. They are principally a pathology of the peripheral nervous system where they involve cutaneous nerves, causing pain and paresthesia. We present a case of a lateral femoral cutaneous nerve angiomyoma and its surgical treatment. A 24-year-old female presented to clinic with right thigh pain in the distribution of the lateral femoral cutaneous nerve, which had been ongoing and progressive for seven months. There was associated numbness and tingling. A lesion was noted in the anterior subcutaneous tissues of the thigh on contrasted CT and MRI. The patient was taken to the operating room where a pearly white lesion was found within the subcutaneous tissue. No effect was seen with stimulation of the lesion. The lesion was removed en bloc, and pathological analysis revealed an angiomyoma. Post-operatively, the patient reported complete resolution of all symptoms, namely, pain and paresthesia. No similar reports were identified within the literature. Together, angiomyomas have been described within the lower extremities to cause pain and paresthesia. This is the first reported case of an angiomyoma involvement within the lateral femoral cutaneous nerve. Complete surgical resection, in this case, was curative and diagnostic.

Laparoscopic removal of rare variant of leiomyoma in the female inguinal canal: a report of two cases

Angioleiomyoma and lipoleiomyoma are rarely found tumors in the inguinal canal. We present two cases of laparoscopic removal of angioleiomyoma and lipoleiomyoma in the female inguinal canal. In Case 1, a 35-year-old woman was admitted to our hospital with left inguinal swelling and intermittent pain. A hypoechoic well-marginated mass was observed on ultrasonography. Laparoscopic complete tumor excision and posterior wall repair were performed, and a diagnosis of angioleiomyoma was confirmed on histopathological evaluation. In Case 2, a 55-year-old woman was admitted with a painful right inguinal swelling. A hypoechoic well-marginated ovoid mass was observed on ultrasonography. Laparoscopic complete tumor excision and posterior wall repair were performed, and a diagnosis of lipoleiomyoma was confirmed on histopathological evaluation. Laparoscopic tumor excision and posterior wall repair are effective treatments of leiomyomas in the inguinal canal.