ABSTRACT
El angioleiomioma (AL) es una neoplasia benigna, bien circunscrita y de crecimiento lento, que representa 5% de las neoplasias de tejidos blandos y cuya etiología es desconocida. Se origina del músculo liso, mayormente de las paredes de los vasos sanguíneos; su localización es más frecuente en extremidades, siendo raros en la región de cabeza y cuello, y más aún en cavidad bucal. Histológicamente la lesión se caracteriza por ser un nódulo bien encapsulado con proliferación de fascículos de músculo liso maduro alrededor de la luz de los vasos sanguíneos, cuyas células suelen ser positivas a marcadores de inmunohistoquímica como alfa actina de músculo liso, desmina, HHF35, miosina, calponina y H-caldesmon. El tratamiento actual es la escisión quirúrgica completa con una tasa de recurrencia prácticamente nula. El objetivo es resaltar la importancia del diagnóstico y el manejo correcto de las lesiones intraorales a través de la presentación de un caso clínico de un leiomioma vascular localizado en región nasolabial, además de hacer la revisión de la literatura correspondiente (AU)
The angioleiomyoma (AL) is a benign neoplasm, well circumscribed and slow growing, that represents 5% of the soft tissue neoplasms, whose etiology is unknown. It originates from smooth muscle, mostly from the walls of blood vessels; regarding its location, it more frequently appears in the extremities, being rare in the head and neck region, and even more so in the oral cavity. Histologically, the lesion is characterized by being a well encapsulated nodule with proliferation of mature smooth muscle bundles around the lumen of the blood vessels, whose cells are usually positive for immunohistochemical markers such as alpha smooth muscle actin, desmin, HHF35, myosin, calponin and H-caldesmon. The current treatment is complete surgical excision having zero recurrence rate. The objective of the following article is to educate on the importance of correct diagnosis and management of intraoral lesions through the presentation of a clinical case of a vascular leiomyoma located in the nasolabial region, in addition to reviewing the corresponding literature (AU)
Subject(s)
Humans , Female , Adult , Soft Tissue Neoplasms , Angiomyoma , Muscle, Smooth , Biopsy , MexicoABSTRACT
RESUMEN: El Leiomioma es una neoplasia benigna originada en el tejido muscular liso por lo que puede manifestarse en cualquier región del cuerpo humano que contenga músculo liso, siendo el sitio más común el útero, la piel y en el tracto gastrointestinal. La escasa cantidad de tejido muscular liso en boca hace que su manifestación oral sea infrecuente, representando solo 0.06 % del total de este tipo de tumores. Los sitios más afectados suelen ser los labios, las mejillas, el paladar, la lengua y encías. Histológicamente se distinguen tres tipos: el Leiomioma Sólido, Angioleiomioma (Vascular) y Leiomioma Epitelioide (Leiomioblastoma). El origen de esta neoplasia en boca suele ser la túnica media de los vasos sanguíneos. El Leiomioma intraóseo suele ser aún menos frecuente, y con un diagnóstico diferencial complejo, con histopatología que en varias ocasiones no suele ser fácil de clasificar. Si bien es definida como un tumor benigno, su manifestación intraósea puede llegar a ser localmente agresiva y con un diagnóstico controversial, debiendo abordarse muchas veces como una neoplasia maligna. El objetivo de este artículo es presentar una revisión de la literatura de esta variante intraósea de Leiomioma situada en mandíbula, sus consideraciones clínicas y un algoritmo de tratamiento.
ABSTRACT: Leiomyoma is a benign neoplasm, the origin is the smooth muscle tissue that can be found in any area of the human body, which contains smooth muscle tissue. The most common regions it can be located, are the uterus, the skin and the gastrointestinal tract. The low quantity of muscle tissue in the mouth leads to infrequent oral manifestation, representing only 0.06 % of these tumors. The most affected regions are the lips, cheeks, palate, tongue and gums. The Histologic classification is: Solid Leiomyoma, Angioleiomyoma (vascular) and Epithelioid Leiomyoma (Leiomyoblastoma). The origin of this tumor in the mouth is the tunica media of the blood vessels. Nevertheless, and in spite of being defined as a benign tumor, it can be extremely aggressive, be subject to controversial diagnosis, and must often be treated as a malign neoplasm. The Intraosseous Leiomyoma is infrequent and presents a complicated differential diagnosis, with a histopathology that many times cannot be easily classified. The aim of this article is to present a review of intraosseous variant Leiomyoma in the mandible, the clinicians´ considerations and a treatment algorithm.
Subject(s)
Humans , Mandibular Neoplasms/diagnostic imaging , Leiomyoma, Epithelioid/diagnosis , Angiomyoma , Leiomyoma/diagnosis , Leiomyoma/pathology , Mouth , Algorithms , Radiography, Panoramic , Mandibular Neoplasms/surgery , Mandibular Neoplasms/pathology , Tomography, X-Ray Computed , Leiomyoma/surgeryABSTRACT
Angioleiomyoma is a rare type of leiomyoma variant and there are a few cases reported to date. Herein, we present a case of angioleiomyoma in a 36-year-old woman with lower abdominal pain, initially diagnosed by degenerated uterine leiomyoma. The transvaginal ultrasonogram showed an ovoid-shaped heterogeneously hyperechoic lesion in left cornual site of uterus and pelvic magnetic resonance image showed an about 5.1 cm sized heterogenous T2 intermediate high mass with poor enhancement. The patient underwent a robot-assisted laparoscopic myomectomy, and final histopathologic diagnosis revealed uterine angioleiomyoma. This case is the first case of angioleiomyoma resected by robotic surgery. The patient is on follow up for over 1 year and shows no evidence of recurrence until now.
Subject(s)
Adult , Female , Humans , Abdominal Pain , Angiomyoma , Diagnosis , Follow-Up Studies , Leiomyoma , Recurrence , Robotic Surgical Procedures , Ultrasonography , Uterine Myomectomy , UterusABSTRACT
Tuberous sclerosis complex is an autosomal dominant disease involving multiple organs and multiple systems. The main manifestation is renal angiomyolipoma in the kidney. It is the most common cause of death in adults, because of its high incidence, rapid growth and bleeding. The incidence of this disease is low and the cognition is not enough, so the diagnosis and treatment are lack of standardization. Recently, the expert consensus of the diagnosis and treatment of tuberous sclerosis related renal angiomyolipoma has been established in China. This content fills the gap in this field in China. With the development of precision medicine, the diagnosis and treatment of such diseases are also progressing.
ABSTRACT
[A BSTR ACT] OB J ECTI V E To i mprove the recognization of clinical, imaging and pathological characteristics of angioleiomyoma (ALM) in the head and neck region. METHODS We retrospectively reviewed the data of 20 patients with ALM in the head and neck region between 2000 and 2012. RESULTS Seven male and 13 female patients were included in this study. The average age was 52.5 (from 28 to 74 years). The symptom in most cases (n=14) was the painless mass, 4 tumors originating in the nasal cavity presented with nasal obstruction or (and) epistaxis, and the other 3 cases were accidentally found by physical examination. The results of B-ultrasonography in 10 ALM cases of subcutaneous or deep space were homogeneously hypoechoic echo texture, straight and linear vessels in the tumor with convergence to one point with a circumscribed margin. MRI in 5 cases demonstrated typically a well-defined mass, which showed hypointensity or isointensity to muscle on T1WI, and heterogeneous hyperintensity on T2WI. All lesions showed obviously delayed enhancement on contrast MRI. HE stain showed that the tumors were formed by bundles of spindle-shape smooth muscle cells circumscribing numerous slit-like blood vessels in most cases. Immunoperoxidase staining revealed that the tumor cells were strongly positive for calponin, desmin and smooth muscle actin (SMA) in the cytoplasm of the smooth muscle cells. The positive expression of progestogen receptor and estrogen receptor was seen in 7 cases and 4 cases respectively among 10 cases. All patients underwent surgery, and recovered well postoperatively without recurrence or malignancy. CONCLUSION The clinical manifestations of ALM are nonspecific. ALM has distinctive imaging features in B-ultrasonic and MRI examination. Histological examination and immunoperoxidase staining can make a definite diagnosis of the disease. Progestogen receptor and estrogen receptor can be expressed in ALM. The postoperative prognosis is good.
ABSTRACT
Vascular leiomyoma may arise from the muscular layer of blood vessel wall, which is extremely rare in the nasal cavity or paranasal sinuses. According to the online search on pubmed and koreamed, only 62 cases with vascular leiomyoma arising from nasal cavity or paranasal sinuses, including 13 cases of the nasal septum, have been reported since the first case was reported in 1966. The authors experienced a case of vascular leiomyoma arising in the left side of nasal septum in a patient. It was successfully removed by trans-nasal approach. In addition, we conducted a literature review of clinical features of the 62 cases of vascular leiomyoma in the nasal cavity.
Subject(s)
Humans , Angiomyoma , Blood Vessels , Leiomyoma , Nasal Cavity , Nasal Septum , Paranasal SinusesABSTRACT
The angiomyoma or vascular leiomyoma is an uncommon type of leiomyoma composed of smooth muscle cells and vascular endothelium. The tumor occurs mostly in the lower extremities as a slowly growing, firm and mobile mass, occasionally accompanied by pain. There are few cases of auricular angiomyoma reported in the literature; however, recently, we experienced a case of a 18-year-old man with protruding auricular mass. We performed a surgical excision and the final pathological result confirmed to angiomyoma. We report this case with a review of the related literatures.
Subject(s)
Adolescent , Humans , Angiomyoma , Ear Auricle , Endothelium, Vascular , Leiomyoma , Lower Extremity , Muscle, Smooth , Myocytes, Smooth MuscleABSTRACT
Leiomiomas são tumores benignos do músculo liso e raros na cavidade oral. este artigo relata um caso clínico de leiomioma vascular oral que acometeu um paciente do sexo masculino, 24 anos de idade, o qual se queixava da presença de uma lesão que crescia e sangrava há 4 anos. ao exame clínico intraoral, observou-se a presença de um tumor de 4cm na maxila direita, assintomático, com sangramento fácil, coloração normal e consistência fibrosa. Na radiografia, observou-se área radiolúcida com pontos de reabsorção óssea no local da lesão. executou-se biópsia incisional, exame histopatológico e imunohistoquímico para a conclusão do diagnóstico de leiomioma vascular oral. O paciente foi encaminhado para a remoção total da lesão, sendo acompanhado há 4 anos, sem índice de recidivas.
Leiomyomas are benign tumors of smooth muscle and are rare in the oral cavity. This paper reports the case of an oral vascular leiomyoma in a 24-year-old male who presented an oral lesion, which "had been growing and bleeding" for four years. On intra-oral clinical examination a 4-cm tumor was observed, located in the right maxilla, asymptomatic, bleeding, with a normal coloration and fibrous consistency. Radiography revealed a radiolucent area with points of bone reabsorption at the site of the lesion. an incisional biopsy, as well as histopathology and imunohistochemistry studies, was carried out, leading to a diagnosis of vascular leiomyoma of the oral cavity. The patient was referred for total removal of the lesion and has been followed for 4 years with no recurrence.
ABSTRACT
Leiomyoma is a benign neoplasm that are thought to originate from the vascular smooth muscle. Leiomyoma more commonly found in the uterus, gastrointestinal tract, and skin. The nasal cavity is an uncommon site for a leiomyoma. We experienced a case of leiomyoma originating in the left nasal vestibule in a 64-year-old female. It was successfully removed by endoscopic surgery, and we report this case with a review of the related literatures.
Subject(s)
Female , Humans , Middle Aged , Angiomyoma , Gastrointestinal Tract , Leiomyoma , Muscle, Smooth, Vascular , Nasal Cavity , Skin , UterusABSTRACT
Leiomyoma is the most common benign neoplasm of the uterus and gastrointestinal tract, but it is rare in the oral cavity. Also, its occurrence in the tongue is very rare because there is so little smooth muscle tissue present in this region. Clinically, oral leiomyoma usually grows slowly and is generally a non-ulcerated, small (1 to 2 cm), painless, sessile, firm and superficial nodule like lesion, although several authors have reported painful lesions. The diagnosis and treatment of oral leiomyoma is possible with complete surgical excision and histological studies by special stains. Recently, we experienced a 42-year-old woman with 6 month history of protruding tongue mass. She underwent surgical excision and the final pathological result confirmed it to be vascular leiomyoma. We report this case with a review of the related literatures.
Subject(s)
Adult , Female , Humans , Angiomyoma , Coloring Agents , Gastrointestinal Tract , Leiomyoma , Mouth , Muscle, Smooth , Tongue , UterusABSTRACT
We report the first case of an angiomyomatous hamartoma (AH) of the popliteal lymph nodes (LNs) occurring in association with diffuse pigmented villonodular synovitis (PVNS) of the knee. AH is a rare benign vascular disease with a predisposition for the LNs of the inguinal region. Twenty-five cases of AH have been reported to date; however, the precise pathogenesis is still undetermined. In the present case, an open synovectomy revealed two of three popliteal LNs in close proximity to the extra-articular component of diffuse PVNS. These LNs demonstrated irregularly distributed thick-walled blood vessels in the hilum. These vessels extended into the medulla and cortex and were associated with haphazardly arranged smooth muscle cells in the sclerotic stroma. These findings are compatible with an AH. Our observations raise the possibility that AH of the popliteal LNs may represent an abnormal proliferative reaction against the inflammatory process caused by PVNS of the knee.
Subject(s)
Angiomyoma , Blood Vessels , Hamartoma , Knee , Lymph Nodes , Myocytes, Smooth Muscle , Synovitis, Pigmented Villonodular , Vascular DiseasesABSTRACT
Objective To explore the CT features of renal epithelioid angiomyolipoma (EAML), and to improve the diagnosis of this disease.Methods The clinical materials and image findings of 15 cases (8 female, 7 male) with renal EAML proved by pathologies were retrospectively studied.Plain and enhancement CT scan were performed in all 15 patients.Nine of the 15 cases were correctly diagnosed and the other were misdiagnosed as renal cell carcinoma (RCC) (n=5), renal oncocytoma (n=1).Results There were some distinctive findings of EAML: (1) Little hypodense or iso-high-density, well defined, round lesion with diameter of 2 to 5 cm.(2) The tumor may involve the medulla of kidney or grow out without haematuria.(3) Most lesions showed obviously uniformity enhancement at artery phase, with a few of them showed inhomogeneous enhancement There were thickening and circuitous vessels in a few lesions.(4) Enhancement mode was quick-in and quick-out.Conclusions CT findings combined with clinical materials have important value in making a correct diagnosis of EAML preoperatively.
ABSTRACT
Vascular leiomyoma (Angiomyoma) is a benign tumor composed of smooth muscle cell and vascular endothelium. Most of them occur at the skin of the lower leg. Cases of vascular leiomyomas developing in the nasal cavity and paranasal sinuses are extremely rare. Most common symptoms are nasal obstruction, epistaxis and nasal pain but none are specific for diagnosis. Complete surgical excision is the treatment of choice and was used in all cases reported. Local recurrence rate is very low. We experienced a case of vascular leiomyoma in the inferior turbinate of a 70-year-old woman who complained of intermittent epistaxis. The tumor was successfully removed via an endoscopic approach. It displayed the characteristic histological findings of abundant thick-walled blood vessels blending with proliferative smooth muscle tissue.
Subject(s)
Aged , Female , Humans , Angiomyoma , Blood Vessels , Endothelium, Vascular , Epistaxis , Leg , Muscle, Smooth , Myocytes, Smooth Muscle , Nasal Cavity , Nasal Obstruction , Paranasal Sinuses , Recurrence , Skin , TurbinatesABSTRACT
Subject(s)
Female , Humans , Angiomyoma , Leiomyoma , Lower Extremity , Mouth , Muscle, Smooth, Vascular , Smooth Muscle Tumor , Subcutaneous TissueABSTRACT
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.
Subject(s)
Humans , Female , Middle Aged , Angiomyoma/diagnosis , Angiomyoma/pathology , Leiomyoma/diagnosis , Leiomyoma/pathology , Mouth Neoplasms/diagnosis , Mouth Neoplasms/pathology , ImmunohistochemistryABSTRACT
Angiomyoma is a rare, benign, mesenchymal tumor occurring mainly in the female genital tract and higher incidence in the fourth to sixth decades of life. It is originated from smooth muscle cells and contains thick-walled vessels. The most satisfactory treatment is complete excision. We experienced a case of the broad ligamentary angiomyoma that was treated by complete excision with a brief review of literature.
Subject(s)
Female , Humans , Angiomyoma , Broad Ligament , Incidence , Myocytes, Smooth MuscleABSTRACT
Angiomyoma is a benign myogenic tumor which can be found wherever smooth muscle is present. They are most commonly found in the alimentary tract, female genito-urinary tract, skin and subcutaneous tissues, but are rare in the area of the head and neck due to the scarcity of smooth muscle tissue. Because of their rarity, these tumors are often clinically misdiagnosed and identified only after histological examination. We present a case of angioleiomyoma which was found in the nasal dorsum and was excised by open rhinoplasty approach.
Subject(s)
Female , Humans , Angiomyoma , Head , Muscle, Smooth , Neck , Rhinoplasty , Skin , Subcutaneous TissueABSTRACT
Leiomyomas are benign myogenic tumors that may occur wherever smooth muscles are present. Most of them are found in the uterus, skin and alimentary tract, but they are rarely found in the upper respiratory tract. Angiomyoma of the nasal cavity and paranasal sinuses are extremely rare owing to the fact that smooth muscles are scarcely found in those regions of the body. To date, of the 25 cases reported, only 7 were located in the inferior turbinate. Surgical excision yields high cure rates. We present an unusual case of angiomyoma arising from the inferior turbinate of nasal cavity that did not present any symptoms except pain or epistaxis.
Subject(s)
Angiomyoma , Epistaxis , Leiomyoma , Muscle, Smooth , Nasal Cavity , Paranasal Sinuses , Respiratory System , Skin , Turbinates , UterusABSTRACT
Objective To describe the MR imaging features and pathologic findings of hepatic angiomyolipoma (HAML), and to evaluate the utility of MR imaging in diagnosis of this tumor. Methods The MR imaging features of eight patients with HAMLs confirmed pathologically were analyzed retrospectively and correlated with pathologic findings. Results Eight patients had a solitary hepatic mass, five (mixed type HAML) of which were diagnosed correctly, and two (1 myomatous type HAML and 1 angiomatous type HAML) of which were diagnosed as hepatic adenoma and focal nodular hyperplasia, and one (mixed type HAML) with hemorrhage and multiple cystic change was mistaken for malignant tumor. Six cases of mixed type HAML exhibited heterogeneously high signal intensity on T 1 and T 2WI. The high signal intensity on T 1WI in five cases disappeared completely after using fat saturation, and most part of the high signal intensity in one case disappeared and some of the high signal intensity remained unchanged after using fat saturation, and multiple cystic change within this mass was detected. One myomatous type HAML and one angiomatous type HAML showed hypointensity on T 1WI and hyperintensity on T 2WI. Multiphase dynamic Gd DTPA enhanced MR scanning was performed in six patients and all those masses showed strong enhancement during arterial phase, and four of which showed moderate enhancement and two slight enhancement during portal venous and delayed phase. Pseudocapsule detected in five cases showed slight enhancement on portal venous and (or) delayed phase. Conclusion MR imaging can reveal the characteristic findings of mixed type HAML and accurate preoperative diagnosis can be made.
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0 05). The correct diagnosis before operation was 0 percent, 63 6% of the patients was diagnosed during operation ( P