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Ward TRW, Eastley NC, Sheikh N, Ashford RU. Intralesional leiomyosarcoma malignant transformation from a biopsied benign angioleiomyoma of the proximal anterior tibia. BMJ Case Rep 2024; 17:e259887. [PMID: 38782435 DOI: 10.1136/bcr-2024-259887] [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] [Indexed: 05/25/2024] Open
Abstract
We present a novel case of a malignant transformation of an extremity soft tissue angioleiomyoma to leiomyosarcoma in a man in his late 70s who presented with a painful and increasing lump on his anterior tibia. Initial imaging and biopsy showed a benign angioleiomyoma which was excised for symptomatic reasons. An analysis of the resulting specimen revealed a 50×42×15 mm smooth muscle neoplasm consistent with angioleiomyoma with a 22×11 mm entirely intralesional nodular component in keeping with a grade 1 leiomyosarcoma. The malignant constituent of the lesion was entirely encased in benign angioleiomyoma negating the need for further surgery. Systemic staging investigation revealed no evidence of metastatic disease spread final staging as per the eighth edition of the American Joint Committee on Cancer (AJCC) Staging T1N0M0 R0 Stage 1 a.
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Affiliation(s)
| | - Nicholas C Eastley
- Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
- East Midlands Sarcoma Service, Leicester, UK
- University of Leicester, Leicester, UK
| | - Nomaan Sheikh
- Trauma Orthopaedics, Kettering General Hospital, Kettering, Northamptonshire, UK
| | - Robert U Ashford
- Trauma and Orthopaedics, University Hospitals of Leicester NHS Trust, Leicester, UK
- East Midlands Sarcoma Service, Leicester, UK
- University of Leicester, Leicester, UK
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2
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Matos M, Soares S, Agaoua M. Current Concepts of Foot and Ankle Angioleiomyoma. J Foot Ankle Surg 2023:S1067-2516(23)00033-9. [PMID: 36941142 DOI: 10.1053/j.jfas.2023.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/22/2023] [Accepted: 02/02/2023] [Indexed: 03/23/2023]
Abstract
Angioleiomyoma is a benign tumor, which arises from the smooth muscle. It comprises approximately 4.4% of all benign soft tissues' neoplasms and they are commonly located at the lower extremities. They are most frequently found in middle-aged women. Angioleiomyoma is usually presented as a painful solitary lesion in the subcutaneous tissue. Due to the lack of evidence in the literature, the aim of this current concepts review was to provide foot and ankle surgeons the most updated and useful information for diagnosis and management of foot or ankle's angioleiomyoma. The possible diagnosis of angioleiomyoma is rarely thought of before surgery. X-ray, US, MRI, aspiration, scintigraphy, CT and EMG make part of the diagnostic tools available and angioleiomyoma's main characteristics in each of the exams are detailed. Angioleiomyoma cannot be neglected as consequence of delay or mistreatment increases morbidity and the potential risk to malignant transformation.
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Affiliation(s)
- Michael Matos
- Department of Orthopaedics, Hôpital Fribourgeois, Villars-sur-Glâne, Switzerland
| | - Sérgio Soares
- Department of Orthopaedics, Hôpital Fribourgeois, Villars-sur-Glâne, Switzerland; Foot and Ankle Unit, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
| | - Mohand Agaoua
- Department of Orthopaedics, Hôpital Fribourgeois, Villars-sur-Glâne, Switzerland
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3
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Abstract
Objective This study was performed to analyze the clinical, radiographic, and pathological features of hand angioleiomyoma causing nerve compression and assess the outcomes of surgical excision. Methods This case series included three men and one woman (mean age, 53.3 years; range, 49–56 years). The patients’ chief complaint was numbness of the fingers. The patients’ medical histories were reviewed, and the diagnosis of angioleiomyoma with nerve compression was confirmed by means of imaging examination and pathological analysis. Results Three tumors occurred in the palm and one in the finger, and the average maximum tumor diameter was 1.8 cm (range, 0.8–2.6 cm). Preoperative magnetic resonance imaging demonstrated well-defined masses with isointense signals on T1 sequences, hyperintense signals on T2 sequences, and strong heterogeneous enhancement after injection of contrast material. All tumors were located near nerves, leading to nerve compression. The diagnosis of angioleiomyoma was confirmed by postoperative pathology. Finger sensation recovered and no recurrence was found during an average follow-up of 37 months (range, 25–59 months). Conclusions Angioleiomyoma should be considered among the differential diagnoses of hand tumors and timely resection should be performed, particularly if the mass is causing numbness and/or pain with positive Tinel’s sign and/or tenderness.
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Affiliation(s)
- Qianjun Jin
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province 310003, P.R. China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province 310003, P.R. China
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Salama K, Merzouki B, Berrada O, Oukessou Y, Rouadi S, Abada RL, Roubal M, Mahtar M. A rare case of a laryngeal leiomyosarcoma with a lymph node metastasis. Int J Surg Case Rep 2021; 82:105830. [PMID: 33838483 PMCID: PMC8045042 DOI: 10.1016/j.ijscr.2021.105830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Leiomyosarcoma is a rare mesenchymal tumor that originates from smooth muscle cells. Head and neck LMSs represent only 3% of all leiomyosarcomas with less than 50 cases of laryngeal LMS reported in the literature till now. CASE PRESENTATION We report a case of 50-year-old male presented at our ENT department for a chronic hoarseness. Clinical examination investigations found small submucosal lesion in the right vocal cord. Treatment consisted of CO2 Laser excision of the lesion. The evolution was marked by the appearance of a tumefaction in the left submandibular region and a severe dyspnea requiring an emergency tracheotomy. Paraclinical examination investigations found a supraglottis-glottis-subglottis tumor. A total laryngectomy with bilateral functional neck dissection was performed and the histopathological examination found a laryngeal leiomyosarcoma. CONCLUSION LMS of the larynx a very rare malignancy. The accurate diagnosis is histological. Surgery is the mainstay of treatment. Its prognosis is correlated to local recurrence and distant metastases.
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Affiliation(s)
- Khadija Salama
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Boutaina Merzouki
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Omar Berrada
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Youssef Oukessou
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Sami Rouadi
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Redallah Larbi Abada
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Mohamed Roubal
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
| | - Mohamed Mahtar
- ENT and Head and Neck Surgery, Hospital August 20, 1953, Ibn Rochd Teaching Hospital, Casablanca, Morocco.
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Ravi S, Chandy LJ, Kumar G, Jacob B, Emmanuel AM. Angioleiomyoma masquerading as shoulder pain. Clin Shoulder Elb 2021; 24:32-35. [PMID: 33652510 PMCID: PMC7943383 DOI: 10.5397/cise.2020.00192] [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: 07/22/2020] [Accepted: 08/29/2020] [Indexed: 11/25/2022] Open
Abstract
Angioleiomyoma is a benign soft tissue tumor originating from vascular smooth muscle. We report a case of a 20-year-old student who presented with pain in the right shoulder of 4 years duration. Shoulder movements were pain-free throughout the range of motion except resisted external rotation. Magnetic resonance imaging visualized a well-circumscribed lesion over the infraspinatus tendon. The lesion was surgically removed and sent for histopathological analysis. Morphology and immunohistochemistry results were suggestive of angioleiomyoma. The most common location for such a lesion is the lower limb, with less than 1% being reported in the upper arm, of which an angioleiomyoma of the shoulder is extremely rare.
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Affiliation(s)
- Surekh Ravi
- Department of Orthopedics, VPS Lakeshore Hospital, Kochi, India
| | - Lazar J Chandy
- Department of Orthopedics, VPS Lakeshore Hospital, Kochi, India
| | - Gautam Kumar
- Department of Orthopedics, VPS Lakeshore Hospital, Kochi, India
| | - Biju Jacob
- Department of Orthopedics, VPS Lakeshore Hospital, Kochi, India
| | - Ami M Emmanuel
- Department of Pathology, VPS Lakeshore Hospital, Kochi, India
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Noreikaite G, Kim S, Horcher A. Epistaxis caused by nasal septum angioleiomyoma. RHINOLOGY ONLINE 2020. [DOI: 10.4193/rhinol/20.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND: Angioleiomyoma is an uncommon, benign tumour originating from vascular smooth muscle. Occurrence in the nasal cavity, especially the nasal septum, is rare with only 16 cases of nasal septal angioleiomyoma reported thus far. We present a new case of nasal septal angioleiomyoma. CASE PRESENTATION: 52-year-old female presented with a three-week history of persistent epistaxis and nasal obstruction. Physical examination revealed a right sided nasal mass originating from the septum. The tumour was endoscopically excised and sent for pathological evaluation which revealed the diagnosis of angioleiomyoma. The patient was followed for six months postoperati- vely and showed no evidence of lesion recurrence. CONCLUSIONS: Because nasal cavity angioleiomyoma recurrence has been reported due to incomplete tumour resection, wide marginal excision is necessary for successful treatment. There have been no cases of malignant transformation of nasal angiolei- omyomas; however, malignant transformation at other sites has been reported. For these reasons, it is important to adequately biopsy and remove angioleiomyoma lesions.
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Angioleiomyoma of the proper ulnar digital artery: Case report. Int J Surg Case Rep 2020; 71:41-44. [PMID: 32438335 PMCID: PMC7240047 DOI: 10.1016/j.ijscr.2020.04.013] [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: 01/11/2020] [Revised: 04/01/2020] [Accepted: 04/16/2020] [Indexed: 11/23/2022] Open
Abstract
Angioleiomyoma is a rare benign tumor comprised of smooth muscle cells. Other than biopsy, no modality of investigation can conclude the diagnosis. Favorable prognosis can be obtained by simple local excision. 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.
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Abstract
BACKGROUND Primary leiomyoma is a rare cause of a mass in the hand, with few reported cases to date. To our knowledge, this constitutes the most comprehensive and up-to-date systematic review of the literature of all cases of primary hand leiomyoma. We also provide an additional case recently managed in our practice of confirmed primary vascular leiomyoma of the hand in a 44-year-old woman to add to the current body of literature. METHODS We performed a comprehensive literature review of all articles published on primary leiomyoma of the hand. The PubMed database was used, with search terms leiomyoma hand, angioleiomyoma hand, and angiomyoma hand. Articles were selected for their accuracy in anatomic localization in the hand and confirmed pathology of leiomyoma. RESULTS Our initial search query resulted in 216 articles. After applying the inclusion criteria, we identified 50 individual articles with 108 cases of confirmed primary leiomyoma in the hand from January 1, 1954, to July 1, 2018. Common initial clinical impressions recorded for primary hand leiomyoma included ganglion cyst, giant-cell tumor, hemangioma, and glomus tumor. Patients presenting with leiomyoma of the hand frequently describe a painful lesion, which differs from most other benign tumors of the hand at presentation. CONCLUSIONS Leiomyoma is an important consideration when developing a differential diagnosis for primary benign masses in the hand. We hope that this comprehensive review can provide increased awareness of this tumor type.
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Kang BS, Shim HS, Kim JH, Kim YM, Bang M, Lim S, Park GM, Lee TY, Ha ND, Kwon WJ. Angioleiomyoma of the Extremities: Findings on Ultrasonography and Magnetic Resonance Imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:1201-1208. [PMID: 30208227 DOI: 10.1002/jum.14798] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/03/2018] [Accepted: 07/27/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The purpose of this study was to describe the features of angioleiomyomas of the extremities on ultrasonography (US) and magnetic resonance imaging (MRI). METHODS We retrospectively reviewed the US and MRI findings of 29 pathologically confirmed cases of angioleiomyomas of the extremities in 29 patients. Twenty patients underwent only US; 7 patients underwent only MRI; and 2 patients underwent US and MRI. Clinical data and histopathologic specimens were reviewed. RESULTS There were 19 women and 10 men. The mean patient age was 48.9 years (range, 23-80 years). On US, angioleiomyomas were located primarily in the subcutaneous fat layer (n = 20 [91%]), were oval (n = 17 [77%]), had well-circumscribed margins (n = 22 [100%]), had hypoechoic protrusions on one or both ends (n = 9 [41%]), had a homogeneous echo texture (n = 17 [ 77%]), had posterior acoustic enhancement (n = 20 [91%]), and had color Doppler flow (n = 20 [91%]). On MRI, the masses showed heterogeneous enhancement (n = 7 [88%]) and enhancing structures on one or both ends (n = 4 [50%]) on contrast-enhanced T1-weighted images. CONCLUSIONS Angioleiomyoma of the extremities is usually a well-circumscribed oval mass with a homogeneous echo texture and occasionally hypoechoic protrusions on US and shows heterogeneous enhancement with occasionally enhancing structures on one or both ends of the mass on MRI. Therefore, it should be included in the differential diagnosis of a soft tissue mass that has protruding structures from one or both ends.
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Affiliation(s)
- Byeong Seong Kang
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Hyun Seok Shim
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Ji Hye Kim
- Department of Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Young-Min Kim
- Department of Pathology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Minseo Bang
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Soyeoun Lim
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Gyeong Min Park
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Tae Young Lee
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Nam-Du Ha
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
| | - Woon Jung Kwon
- Department of Radiology, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
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10
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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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Abstract
Angioleiomyomas are benign tumefactions that originate from smooth muscle in vascular structures and are difficult to definitively diagnose preoperatively. Although these lesions are rarely encountered in the foot, the lower extremity is the most common site of occurrence. An angioleiomyoma typically manifests as a small, painful, solitary, mobile lesion. This case report describes a lateral retromalleolar para-Achilles tendon insertional location for a moderately sized immobile solid tumefaction in the subcutaneous tissues. The lesion was nonpainful and progressively enlarged over 5 years. An excisional biopsy was performed, and the nodular lesion was subsequently diagnosed histopathologically as an angioleiomyoma. Owing to the ambiguous nature of the clinical findings, angioleiomyoma should be included in the differential diagnosis of lower-extremity soft-tissue manifestations.
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Affiliation(s)
- Robert L.B. Sprinkle
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC
| | - Omar P. Sangueza
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Ashleigh E. Wells
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC
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Kulkarni MS, Vijayan S, Naik M, Rao SK. A rare tumour of hand: angioleiomyoma. BMJ Case Rep 2017; 2017:bcr-2017-220005. [PMID: 28455461 DOI: 10.1136/bcr-2017-220005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Angioleiomyoma is a benign tumour composed of smooth muscle and vascular tissue. Because of the paucity of smooth muscles in the hand other than tunica media of the blood vessels, its occurrence is quite rare in the hand and only few cases are reported in the English literature. We present the case of a 49-year-old man with benign painless swelling on the dorsum of hand. Differential diagnosis of ganglion cyst and tendon sheath tumour were considered. However, excision biopsy revealed angioleiomyoma. At 2-year follow-up, the patient remained asymptomatic with no evidence of recurrence.
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Affiliation(s)
- Mahesh Suresh Kulkarni
- Department of Orthopaedics, Kasturba Medical College Manipal, Manipal University, Manipal, India
| | - Sandeep Vijayan
- Department of Orthopaedics, Kasturba Medical College Manipal, Manipal University, Manipal, India
| | - Monappa Naik
- Department of Orthopaedics, Kasturba Medical College Manipal, Manipal University, Manipal, India
| | - Sharath Kumar Rao
- Department of Orthopaedics, Kasturba Medical College Manipal, Manipal University, Manipal, India
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Baarini O, Gilheany M. Angioleiomyoma of the Plantar-Medial Arch: A Case Report. J Clin Diagn Res 2016; 10:PD07-8. [PMID: 27630899 DOI: 10.7860/jcdr/2016/19988.8112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 05/16/2016] [Indexed: 11/24/2022]
Abstract
An angioleiomyoma is a benign soft tissue tumour that arises from smooth muscle layer of blood vessels. The true aetiology of these masses is largely unknown and quite often may not be associated with pain. This paper illustrates the occurrence of an angioleiomyoma in the medial arch of the foot, a previously unreported location. Significant delay occurred in the patient being referred for specialist consultation, after attending numerous general practitioners for management. This highlighted the need for ongoing publication for case reports of this nature. The patient underwent excision with no recurrence of the lesion reported at 12 months. Often masses of this type may be left alone. However, when symptomatic simple excision will suffice where no other surrounding complication exists and where the mass is well encapsulated in the sub cutaneous area.
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Affiliation(s)
- Omar Baarini
- Senior Registrar, Australasian College of Podiatric Surgeons , Australia
| | - Mark Gilheany
- Fellow, Australasian College of Podiatric Surgeons , Australia
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Zhu G, Xiao D, Sun P. Expression of estrogen and progesterone receptors in angioleiomyoma of the nasal cavity of six patients. Oncol Lett 2016; 11:2359-2364. [PMID: 27073480 PMCID: PMC4812515 DOI: 10.3892/ol.2016.4230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 01/18/2016] [Indexed: 11/30/2022] Open
Abstract
Angioleiomyoma of the nasal cavity is extremely rare. There are only a small number of studies in the literature that demonstrate that the estrogen receptor (ER) and progesterone receptor (PR) are expressed in angioleiomyoma, and the results from these studies are inconsistent. The present study identified 6 patients with nasal angioleiomyoma that were treated between 2004 and 2013. All patients underwent endoscopic surgery and were followed-up for 1–10 years. Resected tumors were investigated for the presence of ER and PR using immunoperoxidase staining. Of the 6 patients, 4 were men and 2 were woman. The mean age of the patients was 60.5 years. The tumors of the 6 patients were identified in the nasal septum, middle turbinate, inferior turbinate, lateral wall of the nasal cavity and nasal vestibule. The clinical manifestations reported by the patients consisted of a painless mass, recurrent epistaxis and nasal obstruction. There were no specific features observed in any of the patients using computed tomography or magnetic resonance imaging. All the patients underwent tumor dissection visualized with a nasal endoscope and recovered without recurrence or malignancy of the tumor post-surgery. Hematoxylin and eosin and immunoperoxidase staining confirmed the diagnosis of angioleiomyoma in all patients. In 5 patients the nuclei of the smooth muscle tumor cells markedly expressed ER and PR. To the best of our knowledge, the present study is the first to demonstrate that ER and PR are clearly expressed in nasal angioleiomyoma. The present study suggests that the sex hormones are possibly associated with the growth of angioleiomyoma.
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Affiliation(s)
- Guochen Zhu
- Department of Otolaryngology-Head and Neck Surgery, Wuxi Second People's Hospital, Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214002, P.R. China
| | - Dajiang Xiao
- Department of Otolaryngology-Head and Neck Surgery, Wuxi Second People's Hospital, Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214002, P.R. China
| | - Ping Sun
- Department of Pathology, Wuxi Second People's Hospital, Affiliated to Nanjing Medical University, Wuxi, Jiangsu 214002, P.R. China
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Pozzatti RR, Cordeiro CP, da Cruz JDMA, de Araújo GCS. Leiomyoma in the thumb causing trigger finger. BMJ Case Rep 2015; 2015:bcr-2015-209449. [PMID: 26240097 DOI: 10.1136/bcr-2015-209449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Leiomyoma is a generally benign tumour and common in the uterine smooth muscle. In some cases, it is found in other parts of the human body. In our study, we report the case of a 61-year-old woman with a painless cystic lesion on the first left thumb associated with trigger finger. The first diagnostic hypotheses were ganglionic cyst and giant cell tumour, however, after surgical excision and histological analysis, it was revealed to be a rare leiomyoma of the hand. We report a clinical case and detailed histopathological study, with 12 high-resolution images stained with: H&E, Smooth Muscle Actin, Desmin, S-100 and CD34.
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Angioleiomyoma arising from a digital artery with demonstrable intra-operative anatomy. EUROPEAN JOURNAL OF PLASTIC SURGERY 2015. [DOI: 10.1007/s00238-015-1120-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Kim AY, Choi MS, Jang DS, Lee HY. A rare case of intranasal vascular leiomyoma. BMJ Case Rep 2015; 2015:bcr2014208247. [PMID: 26063111 PMCID: PMC4480081 DOI: 10.1136/bcr-2014-208247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 11/04/2022] Open
Abstract
Vascular leiomyoma (VL) is a solitary and rare form of leiomyoma that usually occurs in the skin or subcutaneous tissue of the lower extremities. Intranasal VL is extremely rare, probably due to the lack of smooth muscle in the nasal cavity. In this study, we report a case of a 70-year-old woman with VL of the inferior nasal turbinate. An endoscopic examination revealed a pinkish globular mass at the inferior turbinate. A preoperative CT scan exhibited a highly enhanced mass originating from the inferior turbinate, and haemangioma was suspected. The patient underwent complete excision of the mass endoscopically, and the histopathological report indicated that the mass was a VL. The tumour was determined to be negative for progesterone and estrogen receptors by immunohistochemical staining. The postoperative period was uneventful. There was no local recurrence during the 12-month follow-up period.
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Affiliation(s)
- Ah-Young Kim
- Department of Otolaryngology Head-Neck Surgery, Eulji University College of Medicine, Daejeon, Republic of Korea
| | - Myoung Su Choi
- Department of Otolaryngology Head-Neck Surgery, Eulji University College of Medicine, Daejeon, Republic of Korea
| | - Dong Sik Jang
- Department of Otolaryngology Head-Neck Surgery, Eulji University College of Medicine, Daejeon, Republic of Korea
| | - Ho Yun Lee
- Department of Otolaryngology Head-Neck Surgery, Eulji University College of Medicine, Daejeon, Republic of Korea
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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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Abstract
Vascular leiomyomas or angioleiomyomas are benign solitary smooth muscular tumours that rarely occur in the distal finger. I report a 64-year-old man with uncommon clinical appearance in the pulp of the middle finger.
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Affiliation(s)
- Hisashi Ohtsuka
- Department of Plastic and Reconstructive Surgery, Saiseikai Imabari Second Hospital , Ehime , Japan
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Houdek MT, Rose PS, Shon W, Kakar S. Angioleiomyoma of the upper extremity. J Hand Surg Am 2013; 38:1579-83. [PMID: 23796716 DOI: 10.1016/j.jhsa.2013.04.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 04/22/2013] [Accepted: 04/23/2013] [Indexed: 02/02/2023]
Abstract
PURPOSE To determine the outcomes of surgical excision in the management of angioleiomyomas of the upper extremity. METHODS We retrospectively reviewed the medical records of 26 patients undergoing a surgical excision of an angioleiomyoma in the upper extremity between 1975 and 2012, who had at least 1 year of follow-up. There were 12 men and 14 women, with an average age of 55 ± 20 years. The most common location was the hand (n = 14). The onset of symptoms was on average 6 ± 5 years before presentation. The most common problem was a painful mass (19 of 26 patients). Average tumor size was 10 ± 7 mm. RESULTS Patients over the age of 60 years tended to have smaller tumors. There was no significant difference between average preoperative and postoperative grip strength in the affected and unaffected extremities. None of the lesions was diagnosed based on radiographic imaging. There was 1 postoperative complication. No recurrence was noted at an average 8.6-year follow-up (range, 1.0-21.0 y). CONCLUSIONS Angioleiomyomas present as a small, painful masses that can be reliably treated with marginal surgical excision. TYPE OF STUDY/LEVEL OF EVIDENCE Therapeutic IV.
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Affiliation(s)
- Matthew T Houdek
- Department of Orthopedic Surgeryhology, Mayo Clinic, Rochester, MN 55905, USA
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Moon IH, Chin SS, Park MK. Preauricular angioleiomyoma. KOREAN JOURNAL OF AUDIOLOGY 2012; 16:138-40. [PMID: 24653889 PMCID: PMC3936666 DOI: 10.7874/kja.2012.16.3.138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 11/28/2012] [Accepted: 11/30/2012] [Indexed: 11/22/2022]
Abstract
Preauricular masses are commonly seen in the otology clinic. Excisional biopsy is essential for diagnosis, and treatment is necessary to reduce the risk of malignancy and for cosmetic purposes. We recently treated a rare case of angioleiomyoma of the preauricular area. Angioleiomyoma is a benign tumor arising from smooth muscle within blood vessel walls. These tumors can arise anywhere in the body; however, they are usually found in the lower extremities and present as a painful mass. Angioleiomyoma of the preauricular area in an elderly person is rare, and only a few cases have been reported. Here, we report the case of an 85-year-old male patient with angioleiomyoma of the preauricular area and provide a literature review.
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Affiliation(s)
- Il Ha Moon
- Department of Otorhinolayngology-Head and Neck Surgery, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Su Sie Chin
- Department of Pathology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Moo Kyun Park
- Department of Otorhinolayngology-Head and Neck Surgery, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
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Abstract
The differential diagnosis of heel pain is extensive. The plantar heel pain is usually due to mechanical etiology, including plantar fasciitis, calcaneal spur, stress fracture, and nerve entrapment. Tumor is a rare cause of plantar heel pain. We present a case of chronic plantar heel pain with a vascular leiomyoma at the heel pad.
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Affiliation(s)
- Man-hong Steve Cheung
- Department of Orthopaedics and Traumatology, North District Hospital, Hong Kong SAR, China
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23
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Miranda LQ, Rehfeldt FVDS, Silva RSD, Fonseca JCM, Alves MDFGS. Case for diagnosis. An Bras Dermatol 2012; 87:322-3. [PMID: 22570046 DOI: 10.1590/s0365-05962012000200026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 05/01/2011] [Indexed: 11/22/2022] Open
Abstract
Vascular leiomyoma are uncommon benign smooth muscle tumors which generally present as a single painful nodule in the lower limbs. We report a case of vascular leiomyoma on the second finger of the left hand, an unusual location for this tumor.
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Affiliation(s)
- Ludmilla Queirós Miranda
- Pedro Ernesto University Hospital, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
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24
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Jalgaonkar A, Mohan A, Dawson-Bowling S, Skinner J, Briggs TWR. Deep soft tissue leiomyoma mimicking fibromatosis in a 5-year-old male. J Foot Ankle Surg 2011; 51:110-3. [PMID: 22078158 DOI: 10.1053/j.jfas.2011.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Indexed: 02/03/2023]
Abstract
Leiomyomas of the deep soft tissue in the extremities of children are very rare. These benign soft tissue tumors occur more frequently in adults between the fourth and sixth decades of age. Women are more commonly affected than men, with the uterus the most common location. We present a rare case of deep soft tissue leiomyoma in the foot of a 5-year-old male. The tumor was misdiagnosed as a desmoid-type fibromatosis from the findings of both magnetic resonance imaging and needle biopsy. The unusual age of presentation, atypical location, and failure of magnetic resonance imaging and ultrasound-guided needle biopsy in diagnosing the lesion make the case interesting. The case also highlights the importance of treating such patients at specialist tertiary centers with a multidisciplinary setting.
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Affiliation(s)
- Azal Jalgaonkar
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, UK.
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25
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Ogura K, Goto T, Nemoto T. Painless giant angioleiomyoma in the subfascia of the lower leg. J Foot Ankle Surg 2011; 51:99-102. [PMID: 21940181 DOI: 10.1053/j.jfas.2011.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Indexed: 02/03/2023]
Abstract
Angioleiomyoma is rare, benign vascular smooth muscle tumor originating from the tunica media of the veins and arteries. It usually presents as a slow-growing, small, and painful mass arising from the cutaneous or subcutaneous tissue. We report an unusual case of angioleiomyoma that was located in the subfascia of the lower leg and had grown to massive size (≤5 cm in diameter) during a 3-year period without pain. A 57-year-old female presented with a 3-year history of a slowly growing pain-free mass on the anterior portion of her right lower leg, just above the ankle joint. Magnetic resonance imaging revealed a well-demarcated lesion, measuring approximately 5 × 4 cm, located deep to the fascia of the anterior compartment of the lower leg and adjacent to the tibia, fibula, and interosseous membrane. The mass was isointense to skeletal muscle on T(1)-weighted images, hyperintense and heterogeneous on T(2)-weighted images, and enhanced intensely and heterogeneously after the intravenous administration of contrast medium. We performed an excision, and histologic analysis revealed smooth muscle cells surrounding blood vessels of various sizes. From these histologic findings, the tumor was diagnosed as a solid form of angioleiomyoma. The present case was unique in that the tumor grew to a massive size without pain and was located deep to the fascia.
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Affiliation(s)
- Koichi Ogura
- Department of Orthopaedic Surgery and Musculoskeletal Oncology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
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26
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Hiromatsu S, Nata S, Tobinaga S, Aoyagi S. A case of angioleiomyoma presenting as a pulsatile tumor in the left ring finger. Ann Vasc Surg 2011; 25:698.e9-12. [PMID: 21546211 DOI: 10.1016/j.avsg.2010.09.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Accepted: 09/25/2010] [Indexed: 10/18/2022]
Abstract
Angioleiomyomas in the finger are rare and their preoperative diagnosis is difficult. Most of them are not associated with arteries and their chief complaint does not reveal pulsation tumor. We report a case of the angioleiomyoma in the finger which was misdiagnosed as arteriovenous fistula of tumor, based on the presence of pulsating tumor and angiography finding.
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Affiliation(s)
- Shinichi Hiromatsu
- Department of Surgery, Kurume University School of Medicine, Fukuoka-ken, Japan.
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27
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28
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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
Angioleiomyomas are rare and benign smooth muscle tumors that are infrequently found in the hand. We present a case of angioleiomyoma of the distal ulnar artery that presented with painless mass and gradual enlargement. 3D computed tomography angiography revealed a mass involved with ulnar artery. Surgical excision was performed, and the histology was characteristic of an angioleiomyoma. The patient became asymptomatic after the operation. At 1-year follow-up after the operation, no recurrence has developed. The purpose of this case report is, furthermore, to consider the differential diagnosis in painless masses of the hand.
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Hayashi M, Tomita S, Fukasawa I, Inaba N. Large angioleiomyoma, rich of mast cell and sex hormone receptor expression. Arch Gynecol Obstet 2008; 279:193-7. [PMID: 18449550 DOI: 10.1007/s00404-008-0663-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Accepted: 04/15/2008] [Indexed: 11/30/2022]
Abstract
BACKGROUND Angioleiomyoma is a rare benign solitary tumor, arising from the vascular smooth muscle. This tumor usually occurs in the subcutis of extremities, uncommonly in abdomen, often presents as a small (<2 cm) and is treated with excision. CASE We report an extremely rare case of unusually large angioleiomyoma, first diagnosed as an ovarian tumor with some malignant possibilities by diagnostic imaging. We resected 1.7 kg of tumor from the extra-peritoneal cavity in the lower abdomen. Histological study revealed that this case's angioleiomyoma had abundant mast cells and sex hormone receptor expression. CONCLUSION This angioleiomyoma is not an obvious malignant tumor because of low mitosis, coagulative necrosis and cellular atypia. However, it seems to have low potential malignancy, because it has massive size, marked degeneration and abundant mast cells. There are some possibilities that sex hormones are related with the growth and degeneration of this case's tumor, because those receptors are strongly expressed in the nucleus of tumor cells.
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Affiliation(s)
- Masaru Hayashi
- Department of Obstetrics and Gynecology, Dokkyo Medical University, Kitakobayashi 880, Mibu, Tochigi, Japan.
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Affiliation(s)
- Aditya V Maheshwari
- 1400 NW 12th Ave, Suite 4036, 4th floor, East Building, Cedars Medical Center, Miami, FL 33136, USA.
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Sonohata M, Okamoto T, Shigematsu M, Mawatari M, Hotokebuchi T. Angioleiomyoma overlying the Achilles tendon. J Orthop Sci 2007; 12:502-4. [PMID: 17909938 DOI: 10.1007/s00776-007-1151-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2007] [Accepted: 04/25/2007] [Indexed: 02/09/2023]
Affiliation(s)
- Motoki Sonohata
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan
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33
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Murata H, Matsui T, Horie N, Sakabe T, Konishi E, Kubo T. Angioleiomyoma with calcification of the heel: report of two cases. Foot Ankle Int 2007; 28:1021-5. [PMID: 17880879 DOI: 10.3113/fai.2007.1021] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Hiroaki Murata
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
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Kugimoto Y, Asami A, Shigematsu M, Hotokebuchi T. Giant vascular leiomyoma with extensive calcification in the forearm. J Orthop Sci 2004; 9:310-3. [PMID: 15168189 DOI: 10.1007/s00776-004-0775-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2002] [Accepted: 02/10/2004] [Indexed: 11/30/2022]
Abstract
Vascular leiomyoma or angioleiomyoma is a benign solitary smooth muscle tumor that occurs in the forearm relatively rarely. Most of these tumors are composed of venous vessels, but in some reports small arteries have been traced in the tumors. We describe a 72-year-old man who presented with a slowly enlarging mass in the distal forearm with extensive calcification. Our case had the following three peculiarities compared with common findings in patients with a vascular leiomyoma: (1) elderly age; (2) giant size tumor; and (3) tumor with extensive calcification. The ulnar artery was involved in the tumor. Simple excision of the tumor, including the ulnar artery, was performed. There was no recurrence and no cold intolerance.
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Affiliation(s)
- Yasutaka Kugimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
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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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36
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37
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Schoenborn A, Maladry D, Le Pelletier F, Mitz V. [Vascular leiomyoma of the hand. Report of a case and review of literature concerning a rare pathology]. ANN CHIR PLAST ESTH 2002; 47:651-5. [PMID: 12577798 DOI: 10.1016/s0294-1260(02)00159-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Vascular leiomyoma is a benign painful tumour that occurs most frequently in the lower extremity. We report an uncommon case in the hand. Only surgical removal of the tumour allows establishing the diagnosis histologically. A review of the literature confirms the rarity of the tumour in the hand. The purpose of this case report is furthermore to consider the differential diagnosis in painful masses of the hand.
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Brooks JK, Nikitakis NG, Goodman NJ, Levy BA. Clinicopathologic characterization of oral angioleiomyomas. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2002; 94:221-7. [PMID: 12221390 DOI: 10.1067/moe.2002.125276] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to better define the clinicopathologic features of oral angioleiomyomas. STUDY DESIGN A retrospective search was performed for angioleiomyomas among all smooth muscle tumors accessioned from 1963 to 2001 in an oral pathology service. Twelve lesions met histopathologic criteria for inclusion in the study and were combined with 97 additional cases identified from the English language literature, yielding 109 cases for evaluation. RESULTS The mean age of the patients with oral angioleiomyomas was 45.0 years, with a 1.43:1 male to female predilection. The most frequently reported site was the lip, in 48.6% of patients, followed by the palate (21.1%), buccal mucosa and tongue (each 9.2%), mandible (8.3%), and buccal sulcus, labial sulcus, floor of mouth, and gingiva (each 0.9%). Most mucosal lesions varied in size from a few millimeters to 2 cm, with most central lesions of the mandible measuring greater than 2 cm. Although angioleiomyomas are vascular lesions, only 55.9% of cases appeared red, blue, or purple; the remainder were gray, white, or the color of normal mucosa. Tumors were typically described as painless and manifested a low growth rate. All lesions were well circumscribed and composed of numerous vascular spaces surrounded by thick smooth muscle walls. CONCLUSION Oral angioleiomyomas are benign smooth muscle tumors with a limited degree of morbidity. Careful histologic inspection is necessary to distinguish these lesions from their malignant counterpart, the leiomyosarcoma. Surgical excision is the treatment of choice, and recurrence is rarely encountered.
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Affiliation(s)
- John K Brooks
- Department of Diagnostic Sciences and Pathology, Baltimore College of Dental Surgery, Dental School, University of Maryland, Baltimore, 21201-1586, USA.
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39
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Abstract
Angioleiomyomas are relatively rare, benign, vascular soft tissue tumors with a predilection for the lower extremity. They may occur in either the cutaneous or subcutaneous tissue and are usually well encapsulated. Erosion of adjacent bone due to secondary compression phenomenon has rarely been reported in the literature. This study describes three cases.
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Affiliation(s)
- B J Yates
- Podiatry Department, La Trobe University, Bundoora, Victoria, Australia.
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40
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Schoenmakers EF, Van de Ven WJ. From chromosome aberrations to the high mobility group protein gene family: evidence for a common genetic denominator in benign solid tumor development. CANCER GENETICS AND CYTOGENETICS 1997; 95:51-8. [PMID: 9140453 DOI: 10.1016/s0165-4608(96)00435-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- E F Schoenmakers
- Laboratory for Molecular Oncology, Center for Human Genetics, University of Leuven, Belgium
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