Vascular leiomyoma presenting as medial joint line pain of the knee

Abstract

Vascular leiomyoma or angioleiomyoma is a rare benign solitary smooth muscle tumor that occurs mostly in the extremities. Most of these tumors are composed of venous vessels, but in some reports small arteries have been detected in the tumors.We present a rare case of a 60-year-old man with a subcutaneous vascular leiomyoma of the right knee. Clinical findings, ultrasound (US), magnetic resonance (MR), and histopathologic features are reported, and the literature is reviewed. The knowledge of specific imaging findings allows to include vascular leiomyoma in the differential diagnosis of lower extremity subcutaneous masses and to achieve an early accurate diagnosis.Sommario Il leiomioma vascolare e o angioleiomioma e è un raro tumore benigno, solitario che si localizza soprattutto a livello delle estremità. Gran parte di questi tumori sono composti di vasi venosi, ma in alcuni reprt sono state trovate delle piccole arterie.Presentiamo qui il caso di un uomo di 60 anni con un leiomioma vascolare sottocutaneo del ginocchio. Rivisitiamo qui la presentazione clinica, l'iconografia, le caratteristiche istopatologiche e la letteratura pertinente. La conoscenza delle caratteristiche specifiche di imaging permette di includere i leiomiomi vascolari nella diagnosi differenziale delle masse sottocutanee dolenti delle estremità e di ottenere una diagnosi precoce e mirata. ª

Vascular Leiomyoma Presenting as Anterior Knee Pain (Case Report)

“…Morimoto defined three subtypes: solid or capillary, cavernous, and venous [ 3 4 ]. Solid is the most frequent, three times as common as in females and typically seen in the lower extremities.…”

“…Solid is the most frequent, three times as common as in females and typically seen in the lower extremities. The cavernous subtype is more common in males than females and involves the head and upper extremities [ 4 5 ]. The most characteristic complaints are pain and tenderness.…”

“…A painful subcutaneus mass in the lower extremities is the typical finding in the solid histological subtype. Differential diagnoses of a leiomyoma are glomus tumor, hemangiomas, angiolipoma, ganglion, schwannoma, giant cell tumor, neurilemoma, traumatic neuromas, and eccrine spiradenoma [ 4 ]. Small malignant lesions cannot be excluded by clinic or MRI alone.…”

“…Hwang et al defined that hyperintens areas on T2-weighted MR images show the smooth muscle and numerous vessels in vascular leiomyomas [ 6 ]. The fibrous capsule defined as a hypointense rim on T2-weighted MRI, with contrast it has marked enhancement that shows its vascular origin [ 4 5 6 7 ].…”

Angioleiomyoma mimicking pes anserinus bursitis: A case report

“…There were no reports of angioleiomyoma mimicking pes anserinus bursitis, and even angioleiomyoma around the knee has been reported rarely, although the lower extremities are the most common site. [2][3][4][5] The location and size of the mass makes the diagnosis more difficult. It is important to know that subcutaneous tiny soft tissue tumors may cause pain and to include angioleiomyoma in the differential diagnosis of refractory pes anserinus bursitis.…”