Case for diagnosis

Abstract

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.

Acral and digital angioleiomyomata: 14‐year experience at the Cleveland Clinic and review of the literature

“…This trend was preserved in our acral angioleiomyoma case series with a 1.6:1 female‐to‐male ratio. In contrast, digital angioleiomyomata do not seem to follow this trend but rather showed an equal gender distribution and 1:1 ratio . Our findings suggesting that the accepted female majority of angioleiomyoma is preserved within the subcategory of acral angioleiomyoma but not in the subcategory of digital angioleiomyoma.…”

“…Angioleiomyomata tend to be painful, with 58% of tumors associated with pain as a symptom or physical exam finding . Our findings suggest that the incidence of pain increases as more distal sites are involved: acral angioleiomyomata were painful in 14 of our 21 cases (67%) and digital angioleiomyomata were painful in 11 of 15 cases (73%) . One case of digital angioleiomyoma did not comment on this feature .…”

“…This is 10 years younger than the mean age of patients in the acral angioleiomyoma series (57 years), although a similar number of patients in this series were in their fourth, fifth or sixth decades (62%). Digital and acral angioleiomyomata did not significantly differ in their mean ages, 56 and 57 years, respectively, but only 44% of digital angioleiomyoma patients were in their fourth, fifth or sixth decades …”

“…Our series of acral angioleiomyoma showed 15 (16%) on the foot and 6 (7%) on the hand, also favoring the lower extremity, although less definitively, at a ratio of 2.5:1. The inverse finding is true, however, for digital angioleiomyomata, which strongly favor the digits of the upper extremities at a ratio of 4.3:1 (Table ) …”

“…Eleven of 15 lesions were painful with 1 case unspecified (Figure ). Clinical impressions prior to histopathologic diagnosis included ganglion cyst, arteriovenous malformation, hemangioma, lipoma and fibroma …”