Epidural angioleiomyoma: an extraordinary cause of compressive myelopathy-MRI findings with histopathological correlation.

BACKGROUND: Angioleiomyomas are benign mesenchymal tumors usually located in the limbs, with anecdotal reports in the spine. We present an atypical case of an epidural spine angioleiomyoma presenting with compressive myelopathy symptoms. The diagnosis was suggested based on MRI findings, and subsequently confirmed histopathologically. RESULTS: This is the first known occurrence of pure spinal epidural angioleiomyoma as a source of compressive myelopathy. The imaging presentation, especially the 'dark reticular sign' on MRI, was crucial in suggesting the diagnosis despite the atypical location CONCLUSION: This report serves to raise awareness among clinicians and radiologists about including angioleiomyoma in differential diagnoses for spinal epidural lesions with indicative MRI features. The favorable outcome after surgical intervention underscores the necessity of swift and accurate diagnosis followed by appropriate treatment for such uncommon spinal tumors.

Angioleiomyoma of the nasolacrimal duct: case report and literature review.

Angioleiomyomas are benign tumors composed of smooth muscle and vascular endothelium. While infrequent in overall prevalence, they are exceptionally rare in the head and neck. Herein, we describe the case of a 65-year-old female who was found to have an angioleiomyoma of the right nasolacrimal duct. Endoscopic excision of the lesion along with medial maxillectomy and dacryocystorhinostomy was performed without complication. The current report is one of the few reported cases of angioleiomyoma of the lacrimal drainage system.

A giant superinfected uterine angioleiomyoma with distant septic metastases: an extremely rare presentation of a benign process and a systematic review of the literature.

PURPOSE: Uterine angioleiomyoma is a rare type of leiomyoma variant and there are few cases reported in the literature. The definitive diagnosis is usually obtained only after the histopathologic examination because there are no specific imaging criteria for this disease. The objective of this article is to review published cases about this clinical condition. METHODS: We report a case of giant angioleiomyoma superinfected by S. agalactiae with the development of latero-cervical distant metastasis in a premenopausal woman. Firstly, the case herein reported was orientated as an endometrial stroma sarcoma in the peri-operative histologic examination by frozen sections. It was treated with laparotomic total hysterectomy, bilateral salpingo-oophorectomy, inframesocolic omentectomy and pelvic and paraaortic lymph node dissection. Postoperative definitive anatomopathological analyses using a proper immunohistochemical panel revealed a case of uterine angioleiomyoma. We also review other case reports published about this clinical condition. RESULTS: We present the first case reported in the literature, in our knowledge, of a giant angioleiomyoma superinfected by S. agalactiae with the development of distant septic metastases. Immunohistochemistry permitted the definitive diagnosis of angioleiomyoma. Treatments previously reported are hysterectomy or tumor resection and any patient recurred. CONCLUSIONS: The definitive diagnosis is usually obtained after the definitive histopathologic examination since the use of immunohistochemical study has an important role in this regard. Complete surgical removal of the lesion is the treatment of choice, with no recurrent cases reported to date.

Angioleiomyoma as a rare cause of a painful subcutaneous nodule in the leg: a case report.

Angioleiomyomas are benign tumors originating in the vascular smooth muscles. The tumor typically presents as a painful, solitary, small subcutaneous nodule. Herein, we have described a case report of chronic leg pain due to angioleiomyoma. We outline the clinical, radiological and histopathological features of this rare diagnosis for a painful nodule of extremity. Although rare, angioleiomyoma should be included in the differential diagnosis of chronic leg pain.

An uncommon cause of lower leg pain.

This article describes a patient with intense pain originating from a benign tumor on her leg. After 7 years of enduring this painful condition with no correct diagnosis, the patient finally underwent a biopsy and excision, which revealed the growth was an angioleiomyoma.

Large pedunculated angiomyofibroblastoma of the vulva with concomitant anemia: a case report and mini review of the literature.

Angiomyofibroblastoma is a rare myxoid tumor and is often seen in vulvar and vaginal area. Patients usually present with a mass on the vulva or labium majus at the premenopausal ages. The lesions are usually between 0.5 cm and ten cm. Lesions have quite cellularity with regular borders under the microscope. Lesions contain numerous veins and bulging stromal cells. Treatment of angiomyofibroblastoma is simple surgical resection. Angiomyofibroblastoma should be differentiated from the other vulvar neoplasms, which need radical surgical treatment, especially from the aggressive angiomyxoma. Hereby, the authors aimed to report a premenopausal women presented with vulvar mass and accompanying anemia. She was diagnosed with angiomyofibroblastoma.

Diagnosis and surgical treatment of cavernous sinus angioleiomyoma: a report of four cases.

OBJECTIVE: The aims of the study were to retrospectively evaluate the imaging characteristics of cavernous sinus angioleiomyoma and explore appropriate surgical approaches. METHODS: A total of four cases admitted to our hospital for repeated episodes of headache were enrolled. The common clinical manifestations included decreased vision, diplopia, blepharoptosis and facial numbness. The first three patients were misdiagnosed with cavernous sinus hemangioma, meningioma and chordoma, respectively. The fourth case was suspected to be angioleiomyoma. Imaging examination showed an oval-shaped tumor occupying the cavernous sinus. The tumor was hypointense on T1-weighted magnetic resonance imaging and extremely hyperintense on T2-weighted scan, which was similar to the cerebrospinal fluid, and was progressively enhanced from one side after gadolinium injection, pushing the internal carotid artery toward the inner side. RESULTS: Surgical resection was performed via an epidural approach for these four cases. Clinical symptoms were improved after surgery and no recurrence was observed during follow-up visits (average, 47.5 months). CONCLUSIONS: The initial symptom of cavernous sinus angioleiomyoma was repeated headache. The tumor seems extremely hyperintense on a T2-weighted image and expansive growth is pushing away the internal carotid artery rather than encasing it. It was progressively enhanced from one side after gadolinium injection. Surgical treatment based on an epidural approach had an excellent outcome in tumor resection and nerve protection.

Uterine angioleiomyoma causing severe abnormal uterine bleeding.

BACKGROUND: Angioleiomyoma or angiomyoma or vascular leiomyoma is an unusual benign mesenchymal neoplasm. The authors present a rare case of large uterine angioleiomyoma causing severe abnormal uterine bleeding. CASE: The patient, a 53-year-old, gravida 2, para 2, premenopausal Greek woman presented with a complaint of severe abnormal uterine bleeding. On gynecologic examination there was a palpable pelvic mass. Preoperative computer tomography (CT) of the abdomen and pelvis revealed an intra-abdominal mass 25 x 15 cm with abnormally increased vascularization. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, total omentectomy and elective pelvic lymph node dissection. Histopathology revealed uterine angioleiomyoma. Follow up 84 months after initial surgery showed no evidence of recurrence. CONCLUSION: Despite the type of surgery, patients with uterine angioleiomyoma have very low risk of recurrence and excellent prognosis.

Angioleiomyoma mimicking a swollen bursa on first metatarsophalangeal joint accompanying with hallux valgus deformity.

We present a case of a patient who underwent a modified scarf osteotomy and tumour excision based on a preoperative diagnosis of hallux valgus deformity and accompanying bursitis. Subsequent histopathological examination revealed that the tumour was an angioleiomyoma. While tumours around the first metatarsophalangeal (MTP) joint are typically associated with gouty nodules, infections, or swollen bursa (bursitis) in patients with hallux valgus deformity, the occurrence of soft tissue tumours in this area is rare. Moreover, angioleiomyoma is an even rarer form of soft tissue tumour and is seldom suspected prior to resection. To our knowledge, there have been no reports of angioleiomyoma arising in the first MTP joint. However, it is important to consider the possibility of an atypical tumour in cases where soft tissue masses are present, even in patients with hallux valgus deformity, and to perform at least imaging tests such as ultrasound and magnetic resonance imaging before surgery. This prospect should always be kept in mind.

Periurethral angioleiomyoma in a female patient.

A 51-year-old white woman, gravida 4, para 3-0-1-3 referred to our urogynecology clinic for evaluation of questionable symptomatic pelvic organ prolapse was found to have a periurethral mass with associated urinary urgency. She underwent transvaginal excision of this mass, and pathology revealed angioleiomyoma. Her urinary urgency has resolved after surgery. No prior periurethral angioleiomyoma has been reported in female patients.

Sonographic appearances of soft tissue angioleiomyomas: differences from other circumscribed soft tissue hypervascular tumors.

OBJECTIVES: The purpose of this study was to evaluate the sonographic features of angioleiomyomas with priority given to the vascular pattern to help in the differential diagnosis from other hypervascular soft tissue tumors. METHODS: The inclusion criteria for this retrospective and nonblinded study were fulfilled in 33 patients with circumscribed hypervascular soft tissue tumors based on pathologic identification. Thirteen cases were angioleiomyomas; 9 cases were nonsubungual glomus tumors; and 11 cases were hemangiomas. Two musculoskeletal radiologists interpreted the results by consensus. Sonographic findings, including the shape, size, echogenicity, vascular pattern, and vascular density of the angioleiomyomas, were compared with those of the other hypervascular tumors. Vascular patterns were categorized into 3 vascular types: 1, several linear vessels clustered in the tumor with convergence to one point; 2, diffusely scattered irregular vessels in the tumor, and 3, one or more vessels that were centrally located. The vascularity of the mass was also categorized as rich (covering >50% of the area of the lesion), moderate (between 20% and 50%), and little (<20%). RESULTS: All of the angioleiomyomas were hypoechoic (100% [13 of 13]), a statistically significant result (P = .001). The type 1 vascular pattern was observed in 69% of the angioleiomyomas (9 of 13; P = .029), and the statistically significant shape was round (38% [5 of 13]; P = .035). CONCLUSIONS: Most angioleiomyomas reveal a homogeneously hypoechoic echo texture with a circumscribed margin and show straight and linear vessels in the tumor with convergence to one point on color Doppler sonography. These characteristics may be helpful when differentiating angioleiomyomas from other circumscribed hypervascular soft tissue tumors.

Toothache induced by an angioleiomyoma of the nasolabial groove: a case report.

Angioleiomyoma, a benign soft tissue tumor composed of smooth muscle cells and vascular endothelium, occurs most commonly in the extremities, the lower leg being a common site of occurrence. It rarely is found in the head and neck area, especially in the nasolabial groove. Surgical excision is the gold standard for diagnosis and treatment of angioleiomyoma; a preoperative diagnosis may be difficult. Here, a case of angioleiomyoma found in the nasolabial groove and associated with toothache is presented.

[Angioleiomyoma utery in a female patient with damaged health condition. Diagnostic and terapeutic difficulties].

35 years old patient with many health problems, on a haemodialysis and a big abdominal tumor originating from the pelvis. The authors share their clinical approach and their diagnostic and terapeutic difficulties in this case and refer to one of their previous publications.

[Excision and tectonic covering of a vascular leiomyoma of the ciliary body with large anterior staphyloma using scleral patch graft]. / Exzision und tektonische Deckung eines vaskulären Leiomyoms des Ziliarkörpers mit großem anteriorem Staphylom mittels Sklerapatch.

Benign tumors of the ciliary body are rare and may potentially be confused with uveal melanoma in clinical routine. Clinical findings rarely allow for safe differentiation. Hence primary excisions are frequent. We report the case of a patient with a benign ciliary tumor, which was observed over a total of 13 years and eventually underwent a local tumor resection.

Primary Intracranial Angioleiomyoma: A Case Report and Literature Review.

BACKGROUND: Angioleiomyoma is a benign soft tissue tumor that manifests as pain and is more common in the extremities. However, primary intracranial angioleiomyoma is an extremely rare entity that is poorly characterized clinically, radiologically, and histopathologically. We compiled and examined reported cases of intracranial angioleiomyoma to provide an up-to-date summary of the condition. A literature search was performed using PubMed with specific key terms. Selected case studies and case series were then compared, and statistical analyses were performed where appropriate. CASE DESCRIPTION: A 59-year-old woman presented with epileptic seizures and a 2-month history of progressive headache. Magnetic resonance imaging of the brain revealed a right temporal pole tumor near the right cavernous sinus. Gross total resection was performed. Histopathologic and immunohistochemical examination demonstrated an angioleiomyoma. No adjuvant radiation or chemotherapy was administered. Magnetic resonance imaging of the brain performed at 6-month follow-up showed no signs of recurrence. CONCLUSIONS: Primary intracranial angioleiomyoma is an exceedingly rare central nervous system tumor. The clinical and radiologic manifestations are nonspecific. The diagnosis depends on the histopathologic and immunohistochemical examination. For patients with clinical symptoms, surgical resection should be the first-choice treatment.

Angioleiomyoma of the inferior turbinate: a rare cause of isolated facial pain.

We present the case of a 33-year-old man with right-sided facial pain. Clinical examination revealed an isolated mass attached to the right inferior turbinate. This was confirmed with computed tomography. Excision was achieved endoscopically and histology revealed an angioleiomyoma. Full symptomatic relief was achieved after surgical excision. Less than 1% of angioleiomyoma lesions are found within the sinonasal cavity. We describe the first documented presentation of angioleiomyoma as a cause of isolated, unilateral facial pain; a very common presentation to the otorhinolaryngology clinic. We promote consideration of angioleiomyoma as a different diagnosis in the presence of facial pain and a unilateral sinonasal lesion. Endoscopic resection provides complete symptomatic resolution.

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.

Tentorial Angioleiomyoma: A Rare Neurosurgical Entity. Case Report and Review of the Literature.

BACKGROUND: Angioleiomyoma (ALM) is a soft tissue neoplasm rarely described in the intracranial site. Because of their uncommon presentation, atypical neuroradiologic and pathologic features, ALMs are often misdiagnosed. CASE DESCRIPTION: We describe the neuroradiologic, clinical, and pathologic data of a 37-year-old male patient suffering from a tentorial ALM. He was admitted at our hospital because of a posterior cranial fossa mass. Magnetic resonance imaging (MRI) showed a left tentorial tumor, hypointense on T1-weighted sequences, with heterogeneous contrast enhancement after gadolinium injection ("salt-and-pepper" fashion) and slightly hyperintense signal on T2-weighted sequence. After surgery, pathological examination showed a tumor composed of several thick-walled blood vessels mixed with a population of deeply eosinophilic spindle-shaped smooth muscle cells arranged in bundles. Necrosis was absent. Neither cellular pleomorphism nor mitoses were detected. Immuno-histochemical analysis confirmed the smooth muscle phenotype of the spindle cell component: diffuse and strong positivity for alpha-smooth muscle actin, desmin, and h-caldesmon. Based on both morphologic and immunohistochemical findings, a diagnosis of primary intracranial ALM was rendered. CONCLUSIONS: We add to the literature the tenth case of this exceedingly rare tumor and submit that ALM should be suspected when a tentorial mass with a "flame-like" time-dependent pattern of contrast enhancement on MRI, a "salt-and-pepper" post-contrast appearance on MRI T1-weighted sequences, and a relation with large intracranial feeding vessels are present.

Angiomyomatous hamartoma of a popliteal lymph node: an unusual cause of posterior knee pain.

Angiomyomatous hamartoma is a primary vascular tumor primarily found in the inguinal and femoral lymph nodes characterized by the replacement of nodal tissue by smooth muscle cells and fibrous tissue in sclerotic lymphatic stroma. There has been 1 report of an angiomyomatous hamartoma of a cervical lymph node, and this is the first reported case occurring in an extremity. We present a case of angiomyomatous hamartoma occurring in a single popliteal lymph node.