Angioleiomioma oral mimetizando um granuloma piogênico: relato de caso raro / Oral Angioleiomyoma mimetizing a pyogenic granuloma: A rare case report

Angioleiomioma (AL) é um tumor benigno de origem perivascular que raramente é observado na cavidade oral, principalmente em localizações como a gengiva. Devido sua apresentação clínica inespecífica, os ALs podem mimetizar outras lesões orais, como tumores benignos de glândulas salivares e lesões reacionais, como o granuloma piogênico. O presente artigo objetiva relatar um caso raro de AL localizado em gengiva, em uma paciente de 19 anos. Clinicamente, a lesão apresentava-se como um tumor assintomático, oval, pedunculado, bem definido, com superfície lisa, consistência fibrosa e cor eritematosa, semelhante a um granuloma piogênico, Uma biópsia excisional foi realizada e o fragmento foi encaminhado para análise histopatológica, que revelou uma proliferação vascular de diversos calibres, contendo paredes musculares espessas e proliferação muscular adjacente, além de infiltrado inflamatório, predominantemente crônico, hemácias extravasadas e área de ulceração, consistente com o diagnóstico de AL inflamado. A histopatologia desempenha um papel importante no diagnóstico final de lesões raras e com características clínicas inespecíficas. A excisão cirúrgica da lesão é o tratamento de escolha mais eficaz para os ALs orais. (AU)

Angioleiomyoma (AL) is a benign tumor of smooth muscle of perivascular origin that is rarely seen in the oral cavity, mainly in locations like the gingiva. Due to their nonspecific clinical presentation, ALs can mimic other oral lesions, such as benign salivary gland tumors and reactional lesions, as a pyogenic granuloma. We reported a case of an AL located in the gingiva in a 19-year-old female patient. In clinical terms, the lesion was presented as an asymptomatic, oval, pedunculated, well-defined nodule with a smooth surface, fibrous consistency and erythematous color, similar to a pyogenic granuloma. An excisional biopsy was performed and the fragment was sent for histopathological analysis that revealed a vascular proliferation of different calibers, containing thick muscle walls and adjacent muscle proliferation, in addition to an inflammatory infiltrate, predominantly chronic, extravasated red blood cells and an area of ulceration, consistent with the diagnosis of inflamed AL. The histopathology plays an important role in the final diagnosis of rare lesions and with nonspecific clinical characteristics. The surgical excision of the lesion is the most effective treatment of choice for oral ALs. (AU)

Angiomiofibroblastoma vulvoperineal, presentación de un caso / Vulvoperineal angiomyofibroblatoma, a case report

An angiomyofibroblastoma is a benign tumor that may present itself in the genital tract of a reproductive age woman. Despite it being a benign neoplasia, unable to be invasive, it can reach large sizes, producing discomfort, pain, and anatomical deformation. A late diagnosis may result in increased surgical difficulty for resection. The following is the clinical case of a woman with a vulvo-perineal tumor of 6 years of evolution, with a final diagnosis of angiomyofibroblastoma, in which complete resection of the lesion was achieved with good cosmetic results. The highlight of this tumor is its slow, silent, but progressive growth, leading to diagnoses that are often confused and late, with a consequent delay in treatment. Among the common differential diagnoses are the Bartholin gland cyst and the aggressive angiomyxoma.

El angiomiofibroblastoma es un tumor benigno que puede presentarse en el tracto genital de la mujer en edad reproductiva. A pesar de ser una neoplasia benigna, sin capacidad invasora, puede alcanzar grandes tamaños, produciendo molestia, dolor y alteración importante de la anatomía. Si el diagnóstico es tardío, aumenta la dificultad quirúrgica en su resección. A continuación, se presenta el caso clínico de una mujer con un tumor vulvoperineal de 6 años de evolución, con diagnóstico final de angiomiofibroblastoma, en el que se logró la resección completa de la lesión con un buen resultado estético. La importancia de este tumor está dada por su crecimiento lento, silencioso, pero progresivo, llevando a que su diagnóstico sea en muchas ocasiones confuso y tardío, con el consecuente retraso en el tratamiento. Dentro de los diagnósticos diferenciales comunes se encuentran el quiste de la glándula de Bartholino y el angiomixoma agresivo.

Angioleiomioma uterino: a propósito de un caso / Uterine angioleiomyoma: report of clinical case

Resumen El angioleiomioma es un tumor benigno perivascular que raramente se localiza en el útero. Se expone el caso de un angioleiomioma de gran tamaño en una mujer de 30 años con sangrado menstrual abundante y masa abdominal palpable. La paciente fue sometida a miomectomía y diagnosticada de angioleiomioma por el estudio histológico. Ante síntomas persistentes, la angiomiomectomía o la histerectomía simple son eficaces.

Abstract Angioleiomyoma is a benign perivascular tumor that is rarely located in the uterus. This paper presents a case of a large angioleiomyoma in a 30-year-old woman with heavy menstrual bleeding and a palpable abdominal mass. The patient underwent myomectomy and was diagnosed with angioleiomyoma by histological examination. For persistent symptoms, angiomyomectomy or simple hysterectomy are effective.

Use of the inverted "T" incision to approach a plantar nodular lesion.

Knowledge of the inverted "T" incision--used in plastic, oncologic and orthopedic surgery--has allowed its adaptation for the diagnostic assessment and therapeutical approach of acral, nodular lesions. The authors describe the use of this technique for the surgical approach of a patient with a plantar nodular lesion, further diagnosed as a calcified angioleiomyoma.

Vascular leiomyoma in the oral cavity.

The aim of this study was to examine a case report of vascular leiomyoma located in the oral mucosa of the oral cavity. Vascular leiomyoma is a benign tumor arising from smooth muscle. One factor that makes vascular leiomyomas in the oral cavity rare is that there is little smooth muscle in the mouth. The most common histological subtype in the oral cavity is the vascular subtype. The greatest difficulty in histological diagnosis of this entity is the similarity in morphology with other malignancies, particularly of neural or fibroblastic lineage. Wide surgical resection is the only treatment reported in the literature with good results. The recurrence rate is very low if complete resection is achieved. The study of rare or unusual lesions is very important for the clinical diagnosis of vascular leiomyoma.

Case for diagnosis.

Vascular leiomyoma are uncommon benign smooth muscle tumors which generally present as a single painful nodule in the lower limbs. We report a case of vascular leiomyoma on the second finger of the left hand, an unusual location for this tumor.

Case for diagnosis / Caso para diagnóstico

Vascular leiomyoma are uncommon benign smooth muscle tumors which generally present as a single painful nodule in the lower limbs. We report a case of vascular leiomyoma on the second finger of the left hand, an unusual location for this tumor.

Angioleiomiomas são tumores benignos raros derivados da musculatura lisa vascular, que geralmente se apresentam como nódulo doloroso solitário nos membros inferiores. Relata-se um caso de angioleiomioma no segundo quirodátilo esquerdo, localização incomum deste tumor.

Congenital cutaneous angioleiomyoma.

Congenital cutaneous angioleiomyoma is an extremely rare benign smooth muscle tumor. We present a case of a firm, painful subcutaneous mass noticed at birth on the left leg that on surgical excision proved to be an angioleiomyoma. Prognosis is good, and recurrences are uncommon. To our knowledge, this is the second report of a congenital angioleiomyoma.

Angioleiomyoma affecting the lips: report of 3 cases and review of the literature.

Angioleiomyoma is an uncommon benign soft tissue tumor usually found in the lower extremities and rarely observed in oral tissues. It is microscopically characterized as a proliferation of smooth muscle cells intermingled with abundant vascular channels. Oral angioleiomyomas affect mostly the lips, palate, buccal mucosa and tongue, and appears as a submucosal painless nodule. Upper lip is seldom affected and only few cases have been reported. We report three additional cases of angioleiomyoma affecting the lips of elderly patients. All lesions were asymptomatic and presented as submucosal nodules of approximately 1cm. Microscopic analysis on H&E sections revealed similar pattern in all cases, showing well-circumscribed and encapsulated tumors characterized by proliferation of smooth muscle cells and large amount of wide vascular spaces of varying sizes. Most tumor cells were immunoreactive for a-smooth muscle actin, desmin and HHF-35. CD34 was also positive on the endothelial cells. All patients were surgically treated and no recurrence was observed so far. The oral pathologists and clinicians should consider this entity when assessing nodular lesions on upper lip.

Angioleiomioma de aleron medial como causa de dolor anterior de rodilla / Angioleiomyoma of the medial patellofemoral ligament: as cause of anterior knee pain

Se presenta un caso de dolor de cara anterior de rodilla de causa turnoral de partes blandas en el alerón patelar medial, en un paciente de 50 años. Se realizó biopsia por resección de la turnoración. El estudio anatomo patológico concluye el diagnóstico de angioleiomioma. No se han hallado citas comunicando dicha localización. A pesar de su limitada dimensión, se presumió la etiología al configurarse el síndrome: dolor más masa palpable.

Angioleiomioma de aleron medial como causa de dolor anterior de rodilla / Angioleiomyoma of the medial patellofemoral ligament: as cause of anterior knee pain

Se presenta un caso de dolor de cara anterior de rodilla de causa turnoral de partes blandas en el alerón patelar medial, en un paciente de 50 años. Se realizó biopsia por resección de la turnoración. El estudio anatomo patológico concluye el diagnóstico de angioleiomioma. No se han hallado citas comunicando dicha localización. A pesar de su limitada dimensión, se presumió la etiología al configurarse el síndrome: dolor más masa palpable.(AU)

Hamartoma nodal angiomiomatoso / Angiomyomatous hamartoma

O Hamartoma Nodal Angiomiomatoso (HNA) é uma doença benigna rara, descrita pela primeira vez em 1992 por Chan et al. Apresenta-se como um tumor vascular primário dos linfonodos que ocorre, na maioria das vezes, exclusivamente nos linfonodos inguinais e femoral, e está ocasionalmente associado a edema de membro inferior ipsilateral. Relata-se o caso de uma paciente de 74 anos, do sexo feminino, com HNA envolvendo linfonodos inguinais direitos; descrevendo seus aspectos patogênicos, clínicos, diagnósticos e terapêuticos. Enfatiza-se a importância do reconhecimento desta patologia para adequado diagnóstico e tratamento. Juntamente com o relato de caso, será realizada breve revisão da literatura (AU)

Angiomyomatous Hamartoma (AH) is a rare benign disease which presents itself as a primary vascular tumor of the lymph nodes, primarily found in the inguinal and femoral lymph nodes and occasionally associated with edema of the ipsilateral limb. Here we report the case of a female patient with AH involving the right inguinal lymph nodes. In addition to the case report, a brief literature review is presented describing the pathogenic, clinical, diagnostic and therapeutic aspects of the condition. The importance of proper recognition of the disease is emphasized for adequate diagnosis and treatment (AU)

Leiomioma vascular bucal: relato de dois casos, revisão da literatura e estudo imuno-histoquímico / Oral vascular leiomyoma: report of two cases, review of literature and immunohistochemistry study

INTRODUÇÃO: Os leiomiomas são neoplasias benignas do músculo liso que ocorrem mais comumente nos tratos geniturinário e gastrintestinal, entretanto são raros na cavidade bucal, na qual provavelmente a maioria desses tumores tem sua origem a partir de músculo liso vascular. OBJETIVOS: Relatar dois casos com história clínica semelhante, confrontando seus aspectos com aqueles encontrados na literatura. RELATO DOS CASOS: Dois casos de mulheres na quinta e sexta décadas de vida apresentando nódulo submucoso em ventre lingual. Após exame microscópico que revelou numerosos vasos sangüíneos entremeados a células fusiformes, com núcleos ovalados ou alongados, e exame imuno-histoquímico com positividade para actina de músculo liso nos dois casos, o diagnóstico final foi leiomioma vascular. CONCLUSÃO: O estudo do leiomioma vascular bucal é de extrema importância devido à raridade e semelhança desse com outras lesões da cavidade bucal. A análise imuno-histoquímica é importante para o diagnóstico final do leiomioma.

INTRODUCTION: The leiomyomas are benign tumors of smooth muscle origin, which are more frequently found in genitourinary and gastrointestinal tracts. However, leiomyomas rarely arise in the oral cavity, and when it happens, the majority of them is originated by smooth muscle of blood vessels. AIMS: Report two cases of oral vascular leiomyoma with similar clinical characteristics, and discuss their aspects with the literature. CASE REPORT: Two cases of vascular leiomyoma in women that presented a nodular mass in the tongue ventral surface were described. The microscopic analysis revealed numerous blood vessels surrounded by spindle cells with ovoid or elongated nuclei. The two cases presented immunopositivity for smooth muscle actin, confirming the diagnosis. CONCLUSION: The study of vascular leiomyoma is required due to its rarity and similar aspects with other oral common lesions. The immunohistochemical analysis is a fundamental tool for the final diagnosis of leiomyoma.

Leiomioma vascular uterino con foco epiteliode: caso clínico / Uterine leiomyoma with a focus epithelioid vascular: clinical case

Los leiomiomas son los tumores mas frecuentes en la mujer y en términos coloquiales se les conoce como "Fibroides" (1). En las variantes infrecuentes de presentación están los leiomiomas vasculares uterinos que son tumores benignos compuestos por células musculares lisas miometriales y vasos sanguíneos de paredes gruesas (2). Presentamos el caso de una femenina hispana de 36 años de edad con tumoración abdominal, trastornos mestruales y dolor pélvico de tres meses de evolución. Se le realizó ecosonograma pélvico y transvaginal que reportó tumor de ovario derecho ecomixto, fue llevada a quirófano teniendo como hallazgo incidental un útero aumentado de tamaño sin alteración de los anexos, tomándose la decisión de concluir el acto operatorio hasta clarificar el diagnóstico. En un segundo tiempo quirúrgico y posterior a estudios complementarios se le realizó histerectomía. En cuanto a los hallazgos histológicos y por estudios de inmunohistoquímica se diagnósticó un leiomioma vascular uterino intramural, con áreas celulares y foco epiteliode.