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Archives of Pathology & Laboratory... Aug 2014Uterine angioleiomyoma is an extremely rare and unique variant of leiomyoma. It usually occurs in middle-aged women, who commonly present with menorrhagia, abdominal... (Review)
Review
Uterine angioleiomyoma is an extremely rare and unique variant of leiomyoma. It usually occurs in middle-aged women, who commonly present with menorrhagia, abdominal pain, or abdominal mass. The lesions are either single or multiple and manifest as submucosal, intramural, or subserosal whorled nodules. Microscopy of the individual nodule shows interlacing fascicles of spindle cells swirling around thick-walled blood vessels. Angioleiomyoma usually lacks mitotic figures, pleomorphism, or necrosis, although cases with marked nuclear atypia and multinucleated giant cells have been reported. The tumor cells are immunoreactive for smooth muscle actin, desmin, h-caldesmon, and progesterone receptor, with a low Ki-67 labeling index. Because these lesions are vascular, they may undergo spontaneous rupture and pose a life-threatening emergency, especially in pregnancy. There are no specific imaging findings; therefore, a preoperative diagnosis is extremely difficult. It is important to recognize this entity and differentiate it from a malignancy, particularly when angioleiomyoma shows significant cytologic atypia or raised cancer antigen 125 levels by thorough sampling. When required, a proper immunohistochemical panel should be used to arrive at a correct diagnosis. In this review, we discuss the current knowledge on uterine angioleiomyoma and its clinical relevance.
Topics: Angiomyoma; Biomarkers, Tumor; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Prognosis; Uterine Neoplasms; Uterus
PubMed: 25076303
DOI: 10.5858/arpa.2013-0315-RS -
European Annals of Otorhinolaryngology,... Feb 2019
Topics: Angiomyoma; Endoscopy; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Nose Neoplasms
PubMed: 30522965
DOI: 10.1016/j.anorl.2018.11.005 -
Clinical Case Reports Sep 2022We describe a rare case of angioleiomyoma in the foot of a middle-aged man.
We describe a rare case of angioleiomyoma in the foot of a middle-aged man.
PubMed: 36188035
DOI: 10.1002/ccr3.6079 -
The American Journal of Case Reports Feb 2023BACKGROUND Primary hepatic angioleiomyoma is a rare mesenchymal tumor that is characterized by blood vessels and smooth muscle. Herein, we report an extremely rare case...
BACKGROUND Primary hepatic angioleiomyoma is a rare mesenchymal tumor that is characterized by blood vessels and smooth muscle. Herein, we report an extremely rare case of primary hepatic angioleiomyoma and discuss the clinicopathological features. CASE REPORT A 60-year-old Mongolian man was diagnosed with a hepatic tumor in the second and third segments of screening in 2012. It had been under control by a physician for 10 years. The patient had discomfort and vague pain in the right side of the abdomen since April 2022. Hepatitis virus markers (hepatitis B and hepatitis C) were negative. Plain computed tomography revealed an 80-mm solitary liver lesion in the left lobe with well-defined margins and heterogeneous enhancement. A left hepatectomy was performed in May 2022. The cut surface of the tumor showed a grayish-white, elastic, hard mass with a diameter of 50×80 mm. Histological findings of the tumor revealed that it was clearly demarcated from the surrounding liver tissues with relatively clear boundaries showing thick, muscle-coated blood vessels with perivascular smooth muscle bundles. Immunohistochemical staining showed that the smooth muscle cells were strongly diffuse and positive for smooth muscle actin. CONCLUSIONS Clinically, primary hepatic angioleiomyoma should be distinguished from other types of liver tumors, especially liver cancer. In combination with our long-term observation and other case reports, we recommend general follow-up if the preoperative pathological diagnosis can be confirmed and the patient has no other symptoms.
Topics: Male; Humans; Middle Aged; Angiomyoma; Liver Neoplasms; Hepatectomy; Abdominal Cavity
PubMed: 36805667
DOI: 10.12659/AJCR.938645 -
Modern Pathology : An Official Journal... Jan 2014Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors... (Review)
Review
Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors with both atypia and mitotic activity are generally diagnosed leiomyosarcomas acknowledging potential for metastasis. However, lesions exist that cannot be comfortably placed in either category, and in such cases the designation 'smooth muscle tumor of uncertain biologic potential' is appropriate. The use of this category is often necessary with limited sampling, such as needle core biopsies. Benign smooth muscle tumors include smooth muscle hamartoma and angioleiomyoma. A specific category of leiomyomas are estrogen-receptor positive ones in women. These are similar to uterine leiomyomas and can occur anywhere in the abdomen and abdominal wall. Leiomyosarcomas can occur at any site, although are more frequent in the retroperitoneum and proximal extremities. They are recognized by likeness to smooth muscle cells but can undergo pleomorphic evolution ('dedifferentiation'). Presence of smooth muscle actin is nearly uniform and desmin-positivity usual. This and the lack of KIT expression separate leiomyosarcoma from GIST, an important problem in abdominal soft tissues. EBV-associated smooth muscle tumors are a specific subcategory occurring in AIDS or post-transplant patients. These tumors can have incomplete smooth muscle differentiation but show nuclear EBER as a diagnostic feature. In contrast to many other soft tissue tumors, genetics of smooth muscle tumors are poorly understood and such diagnostic testing is not yet generally applicable in this histogenetic group. Leiomyosarcomas are known to be genetically complex, often showing 'chaotic' karyotypes including aneuploidy or polyploidy, and no recurrent tumor-specific translocations have been detected.
Topics: Angiomyoma; Biomarkers, Tumor; Cell Differentiation; Hamartoma; Herpesvirus 4, Human; Humans; Leiomyoma; Leiomyosarcoma; Neoplasms, Muscle Tissue; Prognosis; Soft Tissue Neoplasms; Terminology as Topic
PubMed: 24384850
DOI: 10.1038/modpathol.2013.178 -
Dento Maxillo Facial Radiology Oct 2010Angiomyomas of the oral cavity are rare benign vascular neoplasms. In particular, the congenital form has not been reported before in the English language literature. We... (Review)
Review
Angiomyomas of the oral cavity are rare benign vascular neoplasms. In particular, the congenital form has not been reported before in the English language literature. We present a congenital angiomyoma of the tongue that was found on the posterior middle of the tongue in an infant. On MRI, the mass showed an isointense signal to muscle on the T₁ weighted image and a slightly hyperintense signal on the T₂ weighted image. Immunohistochemically, tumour cells were positive to desmin and smooth muscle actin, but negative to vimentin and S100. The treatment was surgical excision and no recurrence was found during the 26 month follow-up period.
Topics: Actins; Angiomyoma; Desmin; Humans; Infant; Magnetic Resonance Imaging; Tongue Neoplasms
PubMed: 20841464
DOI: 10.1259/dmfr/32524441 -
The Journal of International Medical... Jun 2020This study was performed to analyze the clinical, radiographic, and pathological features of hand angioleiomyoma causing nerve compression and assess the outcomes of...
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.
Topics: Angiomyoma; Contrast Media; Female; Hand; Humans; Hypesthesia; Magnetic Resonance Imaging; Male; Middle Aged; Peripheral Nerve Injuries
PubMed: 32567422
DOI: 10.1177/0300060520928683 -
Head and Neck Pathology Dec 2015Angioleiomyoma (ALM; synonyms: angiomyoma, vascular leiomyoma) is an uncommon benign tumor of skin and subcutaneous tissue. Most arise in the extremities (90 %). Head... (Review)
Review
Angioleiomyoma (ALM; synonyms: angiomyoma, vascular leiomyoma) is an uncommon benign tumor of skin and subcutaneous tissue. Most arise in the extremities (90 %). Head and neck ALMs are uncommon (~10 % of all ALMs) and those arising beneath the sinonasal tract mucosa are very rare (<1 %) with 38 cases reported so far. We herein analyzed 16 cases identified from our routine and consultation files. Patients included seven females and nine males aged 25-82 years (mean 58; median 62). Symptoms were intermittent nasal obstruction, sinusitis, recurrent epistaxis, and a slow-growing mass. Fifteen lesions originated within different regions of the nasal cavity and one lesion was detected incidentally in an ethmoid sinus sample. Size range was 6-25 mm (mean 11). Histologically, all lesions were well circumscribed but non-encapsulated and most (12/16) were of the compact solid type superficially mimicking conventional leiomyoma but contained numerous compressed muscular veins. The remainder were of venous (2) and cavernous (2) type. Variable amounts of mature fat were observed in four cases (25 %). Atypia, necrosis, and mitotic activity were absent. Immunohistochemistry showed consistent expression of smooth muscle actin (12/12), h-caldesmon (9/9), muscle-specific actin (4/4), variable expression of desmin (11/14) and CD56 (4/6), and absence of HMB45 expression (0/11). The covering mucosa was ulcerated in 6 cases and showed squamous metaplasia in one case. There were no recurrences after local excision. Submucosal sinonasal ALMs are rare benign tumors similar to their reported cutaneous counterparts with frequent adipocytic differentiation. They should be distinguished from renal-type angiomyolipoma. Simple excision is curative.
Topics: Adult; Aged; Aged, 80 and over; Angiomyoma; Biomarkers, Tumor; Female; Humans; Immunohistochemistry; Male; Middle Aged; Nose Neoplasms; Paranasal Sinus Neoplasms
PubMed: 26047608
DOI: 10.1007/s12105-015-0636-y -
International Journal of Surgery Case... 2017Myopericytoma is a rare tumor of deep soft tissues, originating from pericytes and characterized by numerous thin walled blood vessels.
INTRODUCTION
Myopericytoma is a rare tumor of deep soft tissues, originating from pericytes and characterized by numerous thin walled blood vessels.
CASE REPORT
We report a case of myopericytoma found at the level of the second toe of the right foot.A patient came to the Endocrinology Surgery Department of Catania Polyclinic because of a presence of a small swelling in the plantar region, between the 2nd and 3rd toe of the right foot. At the anatomopathological examination, the escalated lesion showed a neoformation of 0.6 cm in diameter, well circumscribed, capsulated, with myopericytoma diagnosis.
DISCUSSION
Its histopathological appearance is similar to myofibromatic lesions from glomic and angiomyoma tumors. It is a rare tumor that affects all ages with a peak after 50 years 3. The most frequent localization is at the lower extremities, particularly in soft subcutaneous tissues, but can rarely occur in other sites.
CONCLUSION
At the anatomopathological evaluation, the immunohistochemical examination for the correct formulation of the diagnosis is essential and an adequate surgical excision is important.
PubMed: 29545996
DOI: 10.1016/j.ijscr.2017.10.061 -
The Journal of Hand Surgery Mar 1994Vascular leiomyomas or angioleiomyomas are benign solitary smooth muscle tumors that occur uncommonly in the hand. The peak incidence is in the third to fifth decades of... (Review)
Review
Vascular leiomyomas or angioleiomyomas are benign solitary smooth muscle tumors that occur uncommonly in the hand. The peak incidence is in the third to fifth decades of life, and men are more often affected than women. This tumor is rarely diagnosed before surgery. The usual treatment is simple excision of the mass and ligation of feeder vessels. Although the tumors occur anywhere in the hand, there are only two previous cases of vascular leiomyoma involving the digital artery. A recent case of this tumor involving a digital artery documented by arteriography and treated by excision of the mass and end-to-end anastomosis of the artery is presented. The authors review their experience with vascular leiomyomas in the hand and present four cases along with a review of 105 cases found in the English literature.
Topics: Adult; Angiomyoma; Female; Fingers; Hand; Humans; Male; Middle Aged; Soft Tissue Neoplasms; Vascular Diseases
PubMed: 8201195
DOI: 10.1016/0363-5023(94)90020-5