Leiomyoma of the Foot and Ankle: A Case Series

Intraosseous myolipoma of the calcaneus

A man in his 40s presented with an incidental finding of an osteolytic bone lesion. He sustained an ankle injury while inline skating, fracturing his lateral malleolus. Besides the fracture, radiographic imaging on the day of the injury incidentally revealed a well-defined solitary osteolytic lesion with a sclerotic rim within the right calcaneus. MRI showed an intraosseous, fat-containing lesion with focal contrast enhancement, assessed as an intraosseous lipoma with central necrosis. In the pathological analysis of a sample of the lesion an intraosseous myolipoma of the calcaneus was found-an unexpected and extraordinary finding. To prevent pathological fracturing, curettage and bone grafting were performed using autologous iliac crest bone in combination with allogenous bone chips.

Unusual Presentation of Leiomyoma in the Hindfoot

A leiomyoma is a benign smooth muscle tumor that is most commonly found in the uterus. Limited studies have reported leiomyoma of the foot, rendering it an usual finding. We present a case of a 57-year-old female patient who presented to the clinic for a painless mass on the posteromedial side of the right heel. It was diagnosed by the radiologist on MRI as a probable schwannoma. The patient underwent surgical excision of this mass which turned out to be a leiomyoma on pathology report. Although foot leiomyoma is a rare finding, leiomyoma should be listed in the differential diagnosis when evaluating foot soft tissue masses. It is difficult to confirm the diagnosis clinically and radiographically, yet a histologic evaluation can affirm the diagnosis. Surgical excision is the treatment of choice offering immediate symptomatic relief.

Surgical treatment of a hindfoot plantar leiomyoma: A case study

Leiomyomas within the foot are rare and are difficult to diagnose with only the radiographic and clinical picture. They are benign, slow growing, and very rarely cause pain. We present an unusual case of a dermatology referral patient complaining of callus formation on the plantar aspect of the foot as well as shoe discomfort. The mass was believed to be a lipoma or a fibroma but after surgical excision was found to be a leiomyoma. Our case highlights the rarity of this diagnosis and presents a unique surgical technique utilizing a medial approach to the plantar hindfoot for lesion removal.

Pediatric Acral Angioleiomyoma: Report of an Unusual Case and Review of the Literature

BACKGROUND

Angioleiomyoma is a classic painful cutaneous tumor of the limbs of middle aged adults. They are usually a straight-forward histologic diagnosis, being well-circumscribed or encapsulated lesions with both smooth muscle and vascular components.

CASE REPORT

We report the case of an angioleiomyoma on the toe of an 8-year-old girl which displayed an unusual plexiform growth pattern. It was treated successfully with surgical excision, with no recurrence at one month.

CONCLUSIONS

Angioleiomyoma is uncommon in children, particularly at acral sites. We describe the first such lesion to display a plexiform growth pattern.

Angioleiomyoma (Vascular Leiomyoma) Presenting as a Pseudoaneurysm of the Tibialis Posterior Artery

Reported here is the case of a 55-year-old woman presenting to a podiatry clinic with a chief complaint of left heel and ankle pain, who ultimately underwent operative excision of an angioleiomyoma adjacent to the tibialis posterior artery at the level of the medial malleolus. Accompanying this case are images from three modalities through which the defining characteristics of an angioleiomyoma can be appreciated. This case advocates for the inclusion of angioleiomyoma in the preoperative differential diagnosis of a mass presenting as a pseudoaneurysm in the lower extremity, particularly among women in the fourth to sixth decades of life.

Cutaneous Angioleiomyoma - A Rare Cause of Posterior Heel Pain: A Case Report

Heel pain is a common presentation in outpatient clinics. Here, we report a 69-year-old woman who complaint about a painful nodule on her left posterior heel. There was no history of trauma. The lesion developed during ten weeks without any bleeding or ulceration. On examination, we observed a subcutaneous firm nodule of about 1 cm in diameter. The lesion was hypoechoic in diagnostic sonography suggesting a fibromatous tumour, which was removed surgically. Histologic investigations confirmed the diagnosis of cutaneous angioleiomyoma. The occurrence of this benign tumour on the heel is quite uncommon but obvious a possible cause for heel pain. During follow-up, no recurrence was observed.