Angioleiomyoma

Angioleiomyoma is a benign soft tissue tumor that originates from the smooth muscle cells of blood vessels, hence the prefix "angio-" referring to blood vessels and "leiomyoma" indicating a benign tumor of smooth muscle. These tumors are relatively rare and are most commonly found in the lower extremities, particularly in the legs, although they can occur in any part of the body where smooth muscles are present.

Etiology and Pathogenesis

The exact cause of angioleiomyoma is not well understood. However, it is believed to be related to trauma or hormonal factors given its higher prevalence in women. The tumor arises from the tunica media, the middle layer of the vessel wall, which is composed of smooth muscle cells. Genetic factors may also play a role in the development of angioleiomyoma, but research in this area is still ongoing.

Clinical Presentation

Patients with angioleiomyoma typically present with a solitary, well-circumscribed, painful mass. The pain associated with angioleiomyoma is distinctive and may be attributed to the tumor's contractile properties or to local nerve compression. The size of the tumor can vary, but most are less than 2 cm in diameter. Although angioleiomyomas are benign and do not metastasize, their location and associated pain can lead to significant discomfort and functional impairment, depending on their size and location.

Diagnosis

The diagnosis of angioleiomyoma is primarily based on histological examination. Imaging studies such as ultrasound and magnetic resonance imaging (MRI) can be helpful in the preoperative assessment but are not definitive. Histologically, angioleiomyomas are characterized by bundles of smooth muscle cells interspersed with thick-walled vessels. Immunohistochemical staining is often used to confirm the diagnosis, with the tumor cells typically expressing smooth muscle actin (SMA) and desmin.

Treatment

The mainstay of treatment for angioleiomyoma is surgical excision. Complete removal of the tumor is usually curative and associated with a low recurrence rate. Pain relief is typically immediate after the removal of the tumor. In cases where surgery is not feasible or the tumor is asymptomatic, observation may be an option. However, given the benign nature of angioleiomyoma, aggressive treatments beyond surgical excision are rarely required.

Prognosis

The prognosis for individuals with angioleiomyoma is excellent, as these tumors are benign and have a very low rate of recurrence following complete excision. Long-term outcomes are generally favorable, with most patients experiencing complete resolution of symptoms after surgery.

Epidemiology

Angioleiomyomas are rare tumors, with a slight predilection for women. They are most commonly diagnosed in adults between the ages of 30 and 60. There is no known racial or ethnic predisposition for developing angioleiomyoma.