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Warburton C, Patel N, Harris G, Gabor N, Rosenberg AE, Dodds SD, Jose J. Angioleiomyoma in a 52-year-old female wrist: A case report. Radiol Case Rep 2023; 18:2663-2666. [PMID: 37287719 PMCID: PMC10242484 DOI: 10.1016/j.radcr.2023.05.021] [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: 04/16/2023] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Angioleiomyoma is a benign soft tissue tumor arising from vascular smooth muscle and most commonly presents in the lower extremities. We report a case of a 52-year-old right-hand dominant woman who presented with a 2-year history of intermittent, nonradiating left wrist pain, which she described as achy in nature without numbness or tingling. A focused physical examination revealed no edema, no obvious skin changes; there was tenderness over the volar-radial aspect of the left wrist, with an underlying firm, mobile, and palpable soft tissue mass. There was no prior history of trauma or surgery to the affected area. Ultrasound (US) examination demonstrated a 0.6 × 0.6 × 0.4 cm well-defined, oval, hypoechoic soft tissue mass within the volar radial soft tissues of the left wrist. The lesion abutted the radial artery without signs of calcification or necrosis. Color Doppler showed little to no vascularity within the mass nor radial artery thrombosis. Histological analysis revealed an angioleiomyoma arising from the radial artery wall. A case presentation like this would most commonly be due to a volar ganglion cyst; however, it is important to consider other soft tissue masses in differential diagnosis, such as angioleiomyoma, as treatment varies significantly.
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Affiliation(s)
| | - Nikhil Patel
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Griffin Harris
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Noah Gabor
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Andrew E. Rosenberg
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Seth D. Dodds
- Department of Orthopaedic Surgery, University of Miami/Jackson Memorial Hospital, Miami, FL, USA
| | - Jean Jose
- Department of Radiology, University of Miami/Jackson Memorial Hospital, Miami, FL, USA
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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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Palacio Fernández L, Trincado Villa L. Caso clínico: angioleiomioma en el pie. REVISTA ESPAÑOLA DE PODOLOGÍA 2022. [DOI: 10.20986/revesppod.2022.1622/2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ho K, Ireland M, Armanasco PS. Rare Case of a Very Large Angioleiomyoma of the Dorsum Foot. Cureus 2021; 13:e14525. [PMID: 34007773 PMCID: PMC8121210 DOI: 10.7759/cureus.14525] [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] [Indexed: 11/05/2022] Open
Abstract
Angioleiomyomas are relatively rare benign smooth muscle soft tissue tumors which often occur on the extremities. They are rarely diagnosed preoperatively as clinical and radiological examination is often nonspecific and inconclusive. An 80-year-old male presented with a 10-year history of a progressively growing and symptomatic lesion on his right dorsal foot within the first intermetatarsal space. The preoperative diagnosis was suspected to be a neurogenic schwannoma arising from the deep peroneal nerve. Simple excision and histopathology confirmed a diagnosis of angioleiomyoma with nil recurrence or complications. The size of the angioleiomyoma was the second largest reported in literature to date. Angioleiomyomas are often misdiagnosed, and a degree of suspicion should be maintained in patients presenting with lower extremity growing soft tissue tumors.
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Affiliation(s)
- Kevin Ho
- Podiatric Medicine, The University of Western Australia, Perth, AUS.,Podiatric Surgery, Australasian College of Podiatric Surgeons, Perth, AUS
| | | | - Paul S Armanasco
- Podiatric Surgery, Australasian College of Podiatric Surgeons, Perth, AUS
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Dreyer LMA, Eastman D, Atwood R, Johnson LJT. Exophytic Angioleiomyoma on the Plantar Foot. J Am Podiatr Med Assoc 2020; 110:436383. [PMID: 32556226 DOI: 10.7547/19-013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A case describing an O-to-Z double-advancement flap used to treat a 62-year-old woman with a slowly enlarging exophytic mass in the plantar aspect of the right foot is presented. Clinical details, surgical technique, and histologic photographs are described. This case report highlights the rare exophytic presentation of a pedal angioleiomyoma, which has not been described in the literature before.
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Moriarty J, Sottile J, Thakurdial T, Wrzolek M, Liu Y. Angioleiomyoma of the Foot. J Am Podiatr Med Assoc 2019; 109:397-400. [PMID: 31599671 DOI: 10.7547/17-083] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Angioleiomyomas are benign soft-tissue tumors that present painfully and are more commonly found in the extremities. Although benign soft-tissue tumors do not require excision, the clinician may not always know the type of tumor, and patient symptomatology may require removal of the offending body. In this article, we present our case findings of a 45-year-old man presenting with a subcutaneous angioleiomyoma subcalcis.
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Affiliation(s)
- John Moriarty
- Staten Island University Hospital, Staten Island, NY
| | - John Sottile
- Northwell at Staten Island University Hospital, Staten Island, NY
| | | | - Monika Wrzolek
- Northwell at Staten Island University Hospital, Staten Island, NY
| | - Ying Liu
- Northwell at Staten Island University Hospital, Staten Island, NY
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Sedberry SD, Bondi EL, Gazes MI, Blume P. A Case of Vascular Leiomyoma Causing Osseous Malformations in the Foot. J Foot Ankle Surg 2019; 57:1238-1241. [PMID: 29903593 DOI: 10.1053/j.jfas.2018.03.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Indexed: 02/03/2023]
Abstract
A vascular leiomyoma is a vascular soft tissue tumor that is relatively rare and benign. They usually occur as solitary lesions and are well encapsulated. The present study describes a unique case of vascular leiomyoma causing erosions of a metatarsal secondary to compression from the tumor. We present a female in her fourth decade of life with osseous malformations of the third metatarsal that became painful after an acute trauma to the foot.
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Affiliation(s)
- Shelly D Sedberry
- Resident, Podiatric Medicine and Surgery Residency Program, Yale School of Medicine, New Haven, CT.
| | - Elizabeth L Bondi
- Resident, Podiatric Medicine and Surgery Residency Program, Yale School of Medicine, New Haven, CT
| | - Michael I Gazes
- Resident, Podiatric Medicine and Surgery Residency Program, Yale School of Medicine, New Haven, CT
| | - Peter Blume
- Surgeon, Affiliated Foot Surgeons, New Haven, CT; Assistant Clinical Professor, Departments of Surgery, Anesthesia, and Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT
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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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Abstract
Purpose To present rare benign orbital tumors with bone destruction in children who could not be diagnosed pre-surgically and may simulate malignant ones. Methods A retrospective review of cases. Clinical, operative and pathological records in all children with a diagnosis of benign orbital tumors who showed remarkable bone destruction at a tertiary Ophthalmic Center in China between Jan 1, 2000 and Dec 31, 2009 were reviewed. All patients had definitive histopathologic diagnosis. Results Eight patients with benign orbital tumors showed obvious bone destruction, including six cases of eosinophilic granuloma, one case of leiomyoma and one case of primary orbital intraosseous hemangioma. Among them, three patients were females and five patients were males. Tumors were unilateral in all cases, with both the right and left side affected equally. Age ranged from 3 to 7 years (mean 4.1 years). Symptom duration ranged from 1 to 5 weeks (mean 4.8 weeks). Eyelid swelling and palpable mass were the most common complaint. There was no evidence for multifocal involvement in cases with eosinophilic granuloma. Among six patients with eosinophilic granuloma, two were treated with low dose radiation (10 Gy), three received systemic corticosteroid and one was periodically observed only after incisional biopsy or subtotal curettage. There was no postoperative therapeutic intervention in the two patients with leiomyoma and intraosseous hemangioma. All eight patients regained normal vision without local recurrence after a mean follow-up time of 32.8 months. Conclusion Benign orbital tumors such as isolated eosinophilic granuloma, leiomyoma and primary orbital intraosseous hemangioma may show remarkable bone destruction.
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Affiliation(s)
- Il-Jung Park
- Department of Orthopedic Surgery, Clinical Pathology, Holy Family Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Hyoung-Min Kim
- Department of Orthopedic Surgery, Clinical Pathology, Holy Family Hospital, The Catholic University of Korea, Bucheon, Korea
| | - Hee-Jung Lee
- Department of Orthopedic Surgery, Clinical Pathology, Holy Family Hospital, The Catholic University of Korea, Bucheon, Korea
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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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Smith J, Wisniewski SJ, Lee RA. Sonographic and clinical features of angioleiomyoma presenting as a painful Achilles tendon mass. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1365-8. [PMID: 16998115 DOI: 10.7863/jum.2006.25.10.1365] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Jay Smith
- Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, E10, Mayo Building, 200 First St, SW, Rochester, MN 55905, USA.
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Gomez-Dermit V, Gallardo E, Landeras R, Echevarría F, García Barredo R. Subcutaneous angioleiomyomas: gray-scale and color Doppler sonographic appearances. JOURNAL OF CLINICAL ULTRASOUND : JCU 2006; 34:50-4. [PMID: 16547985 DOI: 10.1002/jcu.20145] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
PURPOSE To describe the gray-scale Doppler and sonographic features of a series of subcutaneous angioleiomyomas. METHODS The sonographic appearances of 10 pathologically proven angioleiomyomas were retrospectively reviewed; 4 in women and 6 in men, with an age range from 33 to 77 years. We evaluated size, shape, echo pattern, margins, location, relationships with adjacent structures, and vascularity. Examinations were performed using a multifrequency linear array transducer (9-11 MHz) connected to a Logiq 500 scanner (GE, Milwaukee, Wl). RESULTS All tumors were subcutaneous and located in the extremities (7 in the lower extremities, 3 in the upper extremities). The sizes ranged from 0.6 to 6.4 cm, with an average size of 2 cm. All of the lesions were hypoechoic with well-defined margins, and 9 were oval. Intratumoral calcifications were observed in two patients. Vascularity was easily detected in all of them, and 4 tumors had a clear vascular pedicle. The spectral Doppler analysis performed in 5 cases, revealing a low-resistance arterial waveform in 4 patients. CONCLUSIONS Although angioleiomyomas are uncommon soft tissue tumors, the presence of a well-defined, hypoechoic, vascular subcutaneous tumor in the extremities should raise the possibility of such a diagnosis.
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