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Mohamed MB, Idris M, Bibawy S. Intravascular Myopericytoma: A Case Report. Cureus 2022; 14:e28581. [PMID: 36185870 PMCID: PMC9521300 DOI: 10.7759/cureus.28581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2022] [Indexed: 11/22/2022] Open
Abstract
Myopericytoma is a rare tumor that arises from perivascular myoid cells. Intravascular myopericytoma is an exceptionally rare subtype with a small number of cases reported. Here, we describe the case of a 31-year-old woman who presented with a lump on the dorsum of the right foot for nine months. Imaging indicated that the lesion is in close proximity to the dorsalis pedis vessels. Following surgical excision, the histological analysis revealed a benign neoplasm arising within a vein wall with features of vascular and pericytic differentiation. When using immunohistochemistry, the blood vessels were highlighted by the cluster of differentiation (CD) 31 and smooth muscle actin (SMA) with negative staining for pancytokeratins. These features led to the diagnosis of intravascular myopericytoma.
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Choi GW, Yang JH, Seo HS, Kim WT, Lee MJ, Yoon JR. Myopericytoma around the knee: mimicking a neurogenic tumour. Knee Surg Sports Traumatol Arthrosc 2016; 24:2748-2751. [PMID: 25398367 DOI: 10.1007/s00167-014-3390-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 10/13/2014] [Indexed: 11/25/2022]
Abstract
Myopericytoma is a rare, usually benign soft tissue tumour that arises most commonly in the dermis and subcutaneous soft tissue of the lower extremities. In this article, we present an unusual case of myopericytoma occurring in the deep soft tissue around the knee that mimicked a neurogenic tumour. Myopericytoma can be confused with neurogenic tumour when located in deep soft tissue and adjacent to nerve bundles. Preoperative MRI and colour Doppler ultrasound may help differentiate myopericytoma from neurogenic tumour by revealing the hypervascular nature of the tumour.
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Affiliation(s)
- Gi Won Choi
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-gu, Seoul, 134-791, Korea
| | - Jae Hyuk Yang
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-gu, Seoul, 134-791, Korea
| | - Hyo Seong Seo
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-gu, Seoul, 134-791, Korea
| | - Wan Tae Kim
- Department of Radiology, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-gu, Seoul, 134-791, Korea
| | - Mi Ji Lee
- Department of Pathology, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-gu, Seoul, 134-791, Korea
| | - Jung Ro Yoon
- Department of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-gu, Seoul, 134-791, Korea.
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Díaz-Flores L, Gutiérrez R, Alvarez-Argüelles H, González-Gómez M, García MDP, Díaz-Flores L. Ultrastructure and histogenesis of the acral calcified angioleiomyoma. Ultrastruct Pathol 2015; 40:24-32. [PMID: 26691377 DOI: 10.3109/01913123.2015.1120839] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
We studied the ultrastructure, immunohistochemistry, and histogenesis of the acral calcified angioleiomyoma, observing three concentric zones: (a) pseudocapsular, thin, with spindle-shaped stromal cells (SCs), presenting scarce organelles and expressing CD34, (b) muscular, forming a ring, with smooth muscle cells of heterogenous phenotype (mainly in quantity and thickness of filaments, and in expression of h-caldesmon, αSMA, and desmin), and (c) central, extensive, calcified (spicular and/or star-shaped calcium deposits around collagen fibers), with pericytic involutive vasculature. The intratumoral vessels were thick (several layers of perivascular cells, with a continuum of phenotypes, resembling myopericytoma vessels) and thin (slit-like channels), without adventitial SCs or elastic material. The extratumoral vessels showed adventitial SCs (which contribute to form the tumor pseudocapsule), hyperplasia of the media and intima layers, and/or occlusion of the lumen by a wide, homogenous fibrotic central zone. Histogenetically, the collagenous matrix may act as a mineralization substrate and the calcifying modified pericytes as inductors; intratumoral vessels may originate from the peritumoral vessels or from the vessel where the tumor develops; and extratumoral vessel modifications, mimicking tumor features, concur with a minor repetitive trauma pathogenesis.
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Affiliation(s)
- Lucio Díaz-Flores
- a Department of Anatomy, Pathology, Histology and Radiology, Faculty of Medicine , University of La Laguna , Tenerife , Spain
| | - Ricardo Gutiérrez
- a Department of Anatomy, Pathology, Histology and Radiology, Faculty of Medicine , University of La Laguna , Tenerife , Spain
| | - Hugo Alvarez-Argüelles
- a Department of Anatomy, Pathology, Histology and Radiology, Faculty of Medicine , University of La Laguna , Tenerife , Spain
| | - Miriam González-Gómez
- a Department of Anatomy, Pathology, Histology and Radiology, Faculty of Medicine , University of La Laguna , Tenerife , Spain
| | | | - Lucio Díaz-Flores
- a Department of Anatomy, Pathology, Histology and Radiology, Faculty of Medicine , University of La Laguna , Tenerife , Spain
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Valero J, Salcini JL, Gordillo L, Gallart J, González D, Deus J, Lahoz M. Intravascular myopericytoma in the heel: case report and literature review. Medicine (Baltimore) 2015; 94:e642. [PMID: 25789958 PMCID: PMC4602481 DOI: 10.1097/md.0000000000000642] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Intravascular myopericytoma (IVMP), regarded as a variant of myopericytoma, is a rare tumor. Very few cases have been described, none in the foot.The first case of IVMP located in the heel of the foot is described in this article. A literature review is reported of all cases of IVMP published in the English literature.A 48-year-old man possessed an IVMP on the heel of the right foot. The physical examination and histopathological and ultrasound studies are described. The literature review yielded 5 cases of IVMP, 2 of which were in the thigh and 1 each in the oral mucosa, the periorbital region, and the leg.The possibility that these lesions may be malignant suggests that the histopathological study of vascular tumors should include immunohistochemical tests.
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Affiliation(s)
- José Valero
- From the Department of Human Anatomy and Histology (ML, JV, JG, DG), Department of Surgery (JD), Zaragoza University, Zaragoza, Spain; Department of Podiatry (JLS, LG), Sevilla University, Sevilla, Spain
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Ko JY, Choi WJ, Kang HS, Yu HJ, Park MH. Intravascular myopericytoma: an interesting case of a long-standing large, painful subcutaneous tumor. Pathol Int 2011; 61:161-4. [PMID: 21355959 DOI: 10.1111/j.1440-1827.2010.02628.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Myopericytoma is a benign neoplasm consisting of cells that appear to have a distinct differentiation towards presumed perivascular myoid cells. Amongst myopericytoma, an intravascular variant appears to have been reported only rarely. A 67-year-old man presented with a 15-year history of a painful, slow growing 3 × 3.5 cm sized mass in the subcutis of his right lateral thigh. Histopathological studies showed a subcutaneous mass entirely within the lumen of a vein. The tumor was composed of spindle-shaped myoid-appearing cells in a concentric arrangement, intimately associated with thin-walled vascular channels. Tumor cells were diffusely positive for smooth muscle actin, focally positive for CD34, and negative for desmin and CD31. From these findings, we diagnosed this lesion as intravascular myopericytoma. Unlike previous reports, our case showed a relatively large painful subcutaneous mass, although this tumor has an intravascular nature.
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Affiliation(s)
- Joo Yeon Ko
- Department of Dermatology and Pathology, Hanyang University College of Medicine, Seoul, Korea
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Acral calcified vascular leiomyoma of the skin: a rare clinicopathological variant of cutaneous vascular leiomyomas: report of 3 cases. J Am Acad Dermatol 2008; 59:1000-4. [PMID: 19022102 DOI: 10.1016/j.jaad.2008.07.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 07/05/2008] [Accepted: 07/06/2008] [Indexed: 11/20/2022]
Abstract
BACKGROUND Several histopathologic variants of cutaneous leiomyomas have been recognized. In our consultation dermatopathology practice, we encountered a variant of cutaneous leiomyoma which, to our knowledge, has not been reported. OBJECTIVE We report 3 cases of vascular leiomyomas, all of them manifesting prominent intratumoral calcifications dominating over the residuum of the tumors and occurring on the acral sites. METHODS We conducted a clinicopathological and immunohistochemical study, which is complemented by a literature review. RESULTS All 3 patients were women ranging in age from 57 to 72 years. Each presented clinically with a slowly growing, firm mass. The lesion was painful in two cases. None of the patients had renal disease or endocrine abnormalities. Microscopically, the lesions were a well-circumscribed, non-encapsulated neoplasm composed of mature smooth muscle cells and vascular pattern, which was inconspicuous, but focally dilated blood vessels were present. In all cases, prominent calcifications were present. Immunohistochemically the spindle cells were positive for alpha-smooth muscle actin. LIMITATIONS This study utilizes tissue specimens that all came as consultations; therefore, some inherent selection bias exists. CONCLUSION Acral calcified vascular leiomyoma is a rare clinicopathological variant of leiomyoma which has predilection for acral sites and shows massive calcifications prevailing over the tumor itself.
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Pantanowitz L, Duke WH. Intravascular lesions of the hand. Diagn Pathol 2008; 3:24. [PMID: 18513426 PMCID: PMC2426672 DOI: 10.1186/1746-1596-3-24] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2008] [Accepted: 05/30/2008] [Indexed: 04/13/2023] Open
Abstract
Introduction Intravascular lesions of the hand comprise reactive and neoplastic entities. The clinical diagnosis of such lesions is often difficult, and usually requires pathologic examination. We present the largest series to date of intravascular lesions affecting the hand. Methods A retrospective review of intravascular (arterial and venous) lesions involving the hand was conducted. Data regarding clinicopathologic findings were analyzed. Results We identified 10 patients with intravascular lesions of their hands including thromboemboli (n = 3), reactive intravascular conditions such as papillary endothelial hyperplasia or Masson's tumor (n = 2) and fasciitis (n = 1), as well as vascular neoplasms including pyogenic granuloma (n = 2) and angioleiomyoma (n = 2). Conclusion Blood vessel injury and/or venous thrombosis may predispose to several intravascular lesions of the hand. Recognition of reactive entities from neoplastic conditions is important.
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Affiliation(s)
- Liron Pantanowitz
- Department of Pathology, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
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Ide F, Obara K, Yamada H, Mishima K, Saito I. Intravascular myopericytoma of the oral mucosa: a rare histologic variant in an uncommon location. Virchows Arch 2007; 450:475-7. [PMID: 17265081 DOI: 10.1007/s00428-007-0368-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2006] [Revised: 12/25/2006] [Accepted: 01/02/2007] [Indexed: 11/24/2022]
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Avilés-Izquierdo JA, Lecona-Echeverría M, Lázaro-Ochaita P. [Nodule on the pinna]. ACTAS DERMO-SIFILIOGRAFICAS 2006; 96:626-7. [PMID: 16476312 DOI: 10.1016/s0001-7310(05)73150-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Abstract
BACKGROUND Myopericytoma is a benign tumor composed of cells that show apparent differentiation towards putative perivascular myoid cells called myopericytes. It arises most commonly in the dermis or subcutaneous tissue of the extremities in adults. METHODS We describe a myopericytoma that was unusual in its intravascular location. RESULTS A 54-year-old man presented with a 10-year history of a painful slowly growing 1.5-cm nodule in the subcutaneous tissue of the thigh. Histologic examination of the excised lesion showed that is was entirely contained within the lumen of a vein. It was composed of a proliferation of myoid-appearing spindle cells, which were arranged in a striking concentric pattern around numerous blood vessels, in a manner that accentuated the vessel walls. This pattern is characteristic of myopericytoma. In some areas, fascicles of spindle cells, embedded in a myxoid stroma, bulged into the lumina of lesional vessels, reminiscent of myofibroma/myofibromatosis. Lesional spindle cells were diffusely positive for smooth muscle actin, focally positive for CD34 and were negative for desmin, cytokeratin, S100 protein, HMB-45 and CD31. CONCLUSION This case illustrates that myopericytoma can be entirely intravascular in its location.
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Affiliation(s)
- Máirín E McMenamin
- Department of Dermatopathology, St. John's Institute of Dermatology, St. Thomas' Hospital, London, UK
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