Angioleiomyoma D18.01

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Angiomyoma; Leiomyoma vascular; Myo-Phleboangioma; Vascular Leiomyoma; Vascular smooth muscle hamartoma

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Benign gynaecotropic tumour ( leiomyoma), located deep in the cutaneous and subcutaneous area, painful, consisting of smooth muscle fibres, spontaneously or under pressure or due to temperature differences.

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Predominantly in women in the 4th to 6th decade of life.

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Particularly proximal extremities, especially lower extremities.

Clinical features
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Solitary, mostly painful (> 50% of tumours), 1.0 cm to max. 2.0 cm Ø, firm, skin-coloured nodules in the deep dermis or subcutis.

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  • In the deep dermis (20% of cases) or subcutaneously (80% of cases) sharply encapsulated tumour nodes consisting of strands of densely packed smooth muscle fibres. Either a central vessel lumen or several incised vessels are visible. Depending on the vascularisation and structure of the vessels, solid, cavernous, venous or fatty variants can be distinguished. Cell polymorphisms are detectable in older tumours (degenerative).
  • Immunohistology: Cells are positive for desmin (intermediate filament; see cytoskeleton below).
  • The angiolipoleiomyovarian is the angiolipoleiomyoma of wall-thick vessels with interspersed mature-cell fat tissue. After its excision the tumour remains recurrence-free.

Differential diagnosis
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Glomus tumor, leiomyoma, neurinoma, angiofibroma, dermatofibroma. S.u. ANGLES for other pressure painful tumours of the skin

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Usually not necessary, because of benign tumor and histological random findings. In case of spontaneous or pressure pain, excision may be necessary.

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  1. Chang JY et al (2002) Multiple Epstein-Barr virus-associated subcutaneous angioleiomyomas in a patient with acquired immunodeficiency syndrome. Br J Dermatol 147: 563-567
  2. Domanski HA (2002) Cytologic features of angioleiomyoma: cytologic-histologic study of 10 cases. Diagn cytopathol 27: 161-166
  3. Dominguez-Cherit J et al (2003) Distal digital angioleiomyoma: a case report and review of the literature. Int J Dermatol 42: 141-143
  4. Holst VA et al (2002) Cutaneous smooth muscle neoplasms: clinical features, histologic findings, and treatment options. J Am Acad Dermatol 46: 477-490
  5. Kutzner H et al (2000) Symplastic hemangioma. dermatologist 51: 327-331
  6. Martinez JA et al (1996) Pleomorphic angioleiomyoma. At J Dermatopathol 18: 409-412
  7. Schürmann M et al (2017) Smooth muscle hamartoma in volar skin. Dermatologist 68:916-918.
  8. Shetty SC et al (2002) Angioleiomyoma in the tonsil: an uncommon tumour in a rare site. Br J Oral Maxillofac Surgery 40: 169-171


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Last updated on: 29.10.2020