Rare Case of a Very Large Angioleiomyoma of the Dorsum Foot

Abstract

Angioleiomyomas are relatively rare benign smooth muscle soft tissue tumors which often occur on the extremities. They are rarely diagnosed preoperatively as clinical and radiological examination is often nonspecific and inconclusive. An 80-year-old male presented with a 10-year history of a progressively growing and symptomatic lesion on his right dorsal foot within the first intermetatarsal space. The preoperative diagnosis was suspected to be a neurogenic schwannoma arising from the deep peroneal nerve. Simple excision and histopathology confirmed a diagnosis of angioleiomyoma with nil recurrence or complications. The size of the angioleiomyoma was the second largest reported in literature to date. Angioleiomyomas are often misdiagnosed, and a degree of suspicion should be maintained in patients presenting with lower extremity growing soft tissue tumors.

Angioleiomyoma: Challenging Diagnosis of an Ankle Tumor

“…These hypotheses include pregnancy, hormonal changes, vascular malformations, and venous stasis induced by trauma. None of them was found in our case [4,5]. Another potential etiologic element is heredity, an autosomal dominant inheritance pattern has been cited [4].…”

“…None of them was found in our case [4,5]. Another potential etiologic element is heredity, an autosomal dominant inheritance pattern has been cited [4].…”

“…Considering the angioleiomyoma's chronic nature and the paucity of any recorded familial history, its specific etiology is challenging to determine [4,5]. Therefore, further research report is needed [3][4][5][6].…”

“…The differential diagnosis may include leiomyosarcoma, ganglionic cyst, fibroma, neurofibroma, gouty tophus, glomus tumor, lipoma, and hemangioma [2][3][4][5].…”

“…They are slow-growing masses that can be asymptomatic; as a result, their preoperative diagnosis is relatively rare [1][2][3][4]. This emphasizes how critical it is to further characterize the clinical diagnosis and management of angioleiomyomas in order to raise awareness of this pathology as a potential differential diagnosis for lower extremity soft tissue tumor [4].…”