Intravascular myopericytoma: An interesting case of a long‐standing large, painful subcutaneous tumor

Abstract

Myopericytoma is a benign neoplasm consisting of cells that appear to have a distinct differentiation towards presumed perivascular myoid cells. Amongst myopericytoma, an intravascular variant appears to have been reported only rarely. A 67-year-old man presented with a 15-year history of a painful, slow growing 3 × 3.5 cm sized mass in the subcutis of his right lateral thigh. Histopathological studies showed a subcutaneous mass entirely within the lumen of a vein. The tumor was composed of spindle-shaped myoid-appearing cells in a concentric arrangement, intimately associated with thin-walled vascular channels. Tumor cells were diffusely positive for smooth muscle actin, focally positive for CD34, and negative for desmin and CD31. From these findings, we diagnosed this lesion as intravascular myopericytoma. Unlike previous reports, our case showed a relatively large painful subcutaneous mass, although this tumor has an intravascular nature.

Cutaneous Myopericytoma: A Report of 3 Cases and Review of the Literature

“…A limitation of this approach is that cases of myopericytomas that have been reported under different terminologies in the past are not included in our review. The typical clinical and histopathologic findings of the reported cutaneous myopericytomas is listed in table 1 [ 2 , 4 , 5 , 6 , 7 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Most patients were male (male:female = 1.5:1), and patient age ranged from 13 to 87 years (median = 47 years).…”

Myopericytoma and arterial intimal thickening: the relationship between myopericytes and myointimal cells

“…The four tumors with intraarterial growth described herein displayed the structural and ultrastructural features and the immunohistochemical expression of myopericytomas. Previous works have located some myopericytomas within the lumen of veins and occasionally within arteries 6,14–16,19–21 . We consider this to be intraarterial growth when at least a portion of the tumor was shown inside the original lumen of an artery.…”

“…Myopericytomas mainly occur in the dermis and subcutaneous tissues of the extremities, head and neck in middle‐aged adults, 6 although a wider distribution has been described, with occurrence in different organs 12,13 . Several of the reported myopericytomas showed intravascular growth, 6,14–20 occasionally documented as intraarterial 21…”

Intravascular Myopericytoma in the Heel

“…However, Ide et al 11 refer to a patient who had undergone surgery for a fatty tumor in the same region 9 years before, but they did not believe that this had any direct relationship with the IVMP. Ko et al 14 describe a patient who, for 15 years, had a slowly growing mass in the same area in which the IVMP appeared. In the present case, the torque exerted and the consequent shearing of the soft tissues caused by the pronated subtalar joint could have been 1 of the causes of the pain and perhaps of the trauma/microtrauma etiology of the tumor itself, as is the case with other similar lesions.…”