Subcutaneous Angioleiomyoma: Clinical and Sonographic Features With Histopathologic Correlation

J Ultrasound Med. 2016 Aug;35(8):1669-73. doi: 10.7863/ultra.15.06056. Epub 2016 Jul 1.

Abstract

Objectives: To investigate clinical and sonographic features of subcutaneous angioleiomyoma with histopathologic correlation.

Methods: Clinical features of 141 cases and sonographic appearances of 33 cases of histopathologically proven subcutaneous angioleiomyoma were retrospectively reviewed. Clinical information included patient age, sex, tumor location, and symptoms. Sonographic features included tumor size, location, contour, margin, component, echogenicity, calcifications, and vascularity. Sonograms were analyzed with histopathologic correlation by a single radiologist and a single pathologist.

Results: Clinical features of the 141 cases of angioleiomyoma included the following: 78.0% of the cases (110 of 141) were on the lower leg or ankle; 55.3% of the patients (78 of 141) had pain at the tumor location; the female-to-male ratio was 1.61:1.00, and most cases occurred in patients in the third through sixth decades. Sonographic features of the 33 cases of angioleiomyoma included the following: 85.0% of the cases (28 of 33) were smaller than 20 mm; 94.0% to 97.0% were solid, oval, parallel to the skin, well defined, and homogeneously hypoechoic and without calcifications; 75.8% (25 of 33) were superficially located, close to or in contact with the dermis; and 39.4% (13 of 33) showed low or moderate internal vascularity.

Conclusions: Typical clinical and sonographic features of angioleiomyoma may include a female patient with a painful lower leg or ankle subcutaneous mass, a superficial location, especially in contact with the dermis, a small size (<20 mm), an oval shape, a parallel orientation to the skin, well-defined margins, complete solid components, homogeneous hypoechogenicity, low or moderate vascular density, and absence of calcifications.

Keywords: angioleiomyoma; musculoskeletal ultrasound; soft tissue mass; sonography; vascular leiomyoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Angiomyoma / diagnostic imaging*
  • Angiomyoma / pathology*
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Neoplasms, Connective Tissue / diagnostic imaging*
  • Neoplasms, Connective Tissue / pathology*
  • Retrospective Studies
  • Ultrasonography / methods*
  • Young Adult