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Case Report| Volume 49, ISSUE 4, P398.e9-398.e15, July 2010

Angioleiomyoma in the Ankle Mimicking Tarsal Tunnel Syndrome: A Case Report and Review of the Literature

      Abstract

      We present the case of a 64-year-old woman with a subcutaneous vascular leiomyoma in the tarsal tunnel in the ankle. The patient presented with pain of several years' duration in the medial aspect of the ankle in the retromalleolar region corresponding to the tarsal tunnel and associated with a subcutaneous mass. We report the clinical manifestation, the imaging and histopathologic features, and a review of the literature. Vascular leiomyomas are part of the differential diagnosis of painful subcutaneous masses in the lower extremity.

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      References

        • Ramesh P.
        • Annapureddy S.R.
        • Khan F.
        • Sutaria P.D.
        Angioleiomyma: a clinical, pathological and radiological review.
        Int J Clin Pract. 2004; 58: 587-591
        • Berlin S.J.
        A review of 2720 lesions of the foot.
        J Am Podiatry Assoc. 1980; 70: 318-324
      1. Enzinger FM, Weiss SW. Benign tumors of smooth muscle. pp 383–401, CV Mosby, St Louis, 1995.

      2. Piers W, Terrono AL, Hayek J, Millender LH. Angiomyoma (vascular leiomyoma) of the median nerve. J Hand Surg. July 12:285–286, 1995.

        • Scott W.W.
        • Hruban R.H.
        • Campbell J.N.
        • et al.
        Angioleiomyoma involving the sciatic nerve: CT demonstration.
        Clin Imaging. 1993; 17: 260-262
        • Hasegawa T.
        • Seki K.
        • Yang P.
        • Hirose T.
        • Hizawa K.
        Mechanism of pain and cytoskeletal properties in angioleiomyomas: an immunohistochemical study.
        Pathol Int. 1994; 44: 66-72
        • Stout A.P.
        Solitary cutaneous and subcutaneous leiomyoma.
        Am J Cancer. 1937; 29: 435-469
        • Katenkamp D.
        • Kosmehl H.
        • Langbein L.
        Angiomyoma pathological analysis of 229 cases.
        Zentralbl Allg Pathol. 1988; 134: 423-433
        • Fletcher C.D.
        • Unni K.K.
        • Mertens F.
        World Health Organization Classification of Tumours: Pathology and Genetics of Tumours of Soft Tissue and Bone.
        IARC Press, Lyon2002
        • Jougla E.
        • Grolleau J.L.
        • Chavoin J.P.
        Angioleiomyoma of the hand: a post traumatic tumor?.
        Chir Main. 1999; 18: 216-219
        • Ekestrom S.
        A comparison between glomus tumour and angioleiomyoma.
        Acta Pathol Microbiol Scand. 1950; 27: 86-93
        • Hachisuga T.
        • Hashimoto H.
        • Enjoji M.
        Angioleiomyoma: a clinicopathologic reappraisal of 562 cases.
        Cancer. 1984; 54: 126-130
        • Duhig J.T.
        • Ayer J.P.
        Vascular leiomyoma, a study of sixty-one cases.
        Arch Pathol Lab Med. 1959; 68: 424-430
        • Magner D.
        • Hill D.P.
        Encapsulated angiomyoma of the skin and subcutaneous tissue.
        Am J Clin Pathol. 1961; 35: 137-141
        • Tsoutsouris G.
        Vascular leiomyoma.
        J Foot Surg. 1982; 21: 37-40
        • Matsuyama A.
        • Hisaoka M.
        • Hashimoto H.
        Angioleiomyoma: A clinicopathologic and immunohistochemical reappraisal with special reference to the correlation with myopericytoma.
        Human Pathology. 2007; 38: 645-651
        • Kinoshita T.
        • Ishii K.
        • Abe Y.
        • Naganuma H.
        Angiomyoma of the lower extremity: MR findings.
        Skeletal Radiol. 1997; 26: 443-445
        • Kataoka M.
        • Yano H.
        • Fukunaga T.
        • Masumi S.
        Giant vascular leiomyoma in the hand.
        Scand J Plast Reconstr Surg Hand Surg. 1997; 31: 91-93
        • Kugimoto Y.
        • Asami A.
        • Shigematsu M.
        • Hotokebuchi T.
        Giant vascular leiomyoma with extensive calcification in the forearm.
        J Orthop Sci. 2004; 9: 310-313
        • Nagata S.
        • Nishimura H.
        • Uchida M.
        • Hayabuchi N.
        • Zenmyou M.
        • Fukahori S.
        Giant angioleiomyoma in extremity: report of two cases.
        Magn Reson Med Sci. 2006; 5: 113-118
        • Freedman A.M.
        • Meland N.B.
        Angioleiomyomas of the extremities: report of a case and review of the mayo clinic experience.
        Plast Reconstr Surg. 1989; 83: 328-331
        • Hildreth D.H.
        The ischemic test for glomus tumor. A new diagnostic test.
        Rev Surg. 1970; 27: 147-148
        • Calonje E.
        • Flechter C.D.M.
        • Wilson-Jones E.
        • Rosai J.
        Retiform hemangioendothelioma: a distinctive form of low-grade angiosarcoma delineated in a series of 15 cases.
        Am J Surg Pathol. 1994; 18: 115-125
        • Chow J.
        • Sabet L.M.
        • Clark B.L.
        • Coire C.I.
        Cutaneous leiomyosarcoma: case reports and review of the literature.
        Ann Plastic Surg. 1987; 18: 319-322
        • Dehart M.M.
        • Bowyer M.W.
        • Silenas R.
        Leiomyosarcoma of the skin and subcutaneous tissue of the hand and wrist.
        J Hand Surg 17A. 1992; 3: 481-483
        • Hewan-Lowe K.
        • Furlong B.
        Leiomyosarcoma of the upper extremity.
        Ultrastruct Pathol. 1993; 17: 241-250
        • Janjan N.A.
        • Anderson T.
        • Seigel R.
        • Hackbarth D.
        Angiosarcoma of the forearm definitively treated by hyperfractionated irradiation.
        Am J Clin Oncol. 1990; 13: 489-494
        • Sanders J.O.
        • Weiland A.J.
        • Moore J.R.
        Leiomyosarcoma of the forearm: treatment with wide local excision and a lateral arm flap.
        J Hand Surg 11A. 1986; 6: 906-910
        • Varela-Duran J.
        • Oliva H.
        • Rosai J.
        Vasculkar leiomyosarcoma: the malignant counterpart of vascular leiomyoma.
        Cancer. 1979; 44: 1684-1691
        • Wolf K.
        • Pasquino J.
        Cutaneous angiosarcoma: a literature review and case report.
        J Am Podiatr Assoc. 1990; 80: 501-504
        • Zacher J.
        • Wessinhage D.
        • Mohr W.
        Subkutanes leiomyosarkom der hand.
        Handchir Mikrochir Plast Chir. 1986; 18: 331-335
        • Visalli A.J.
        • McCarthy D.J.
        Podriatic considerations of angioleiomyoma.
        J Foot Surg. 1992; 31: 372-377
        • Hanft J.R.
        • Carbonell J.A.
        • Do H.Q.
        Angioleiomyoma of the lower extremity.
        J Am Podiatr Med Assoc. 1997; 87: 388-391
        • Herren D.
        • Zimmermann A.
        • Buchler U.
        Vascular leiomyoma in an index finger undergoing malignant transformation.
        J Hand Surg (Br). 1995; 20: 484-487
        • Bulmer J.H.
        Smooth muscle tumours of the limbs.
        J Bone Joint Surg Br. 1967; 49: 52-58
        • Brenton G.E.
        • Johnson D.E.
        • Eady J.L.
        Leiomyosarcoma of the hand and wrist: report of two cases.
        J Bone Joint Surg. 1986; 68A: 139-142
        • Russel W.O.
        • Cohen J.
        • Enzinger F.M.
        A clinical and pathological staging system for soft tissue sarcomas.
        Cancer. 1977; 40: 1562-1570
        • Neviaser R.J.
        • Newman W.
        Dermal angiomyoma of the upper extremity.
        J Hand Surg. 1977; 2: 271-274
        • Shapiro J.D.
        • Froimson A.I.
        Angiomyoma in the hand.
        Orthopaedics. 1988; 11: 1709-1710
        • Hwang J.W.
        • Ahn J.M.
        • Kang H.S.
        • Suh J.S.
        • Kim S.M.
        • Seo J.W.
        Vascular leiomyoma of an extremity: MR imaging-pathology correlation.
        AJR Am J Roentgenol. 1998; 171: 981-985
        • Moromoto N. Angiomyoma
        (vascular leiomyoma): a clinicopathologic study.
        Med J Kagoshima Univ. 1973; 24: 663-683
        • Domanski H.A.
        Cytologic features of angioleiomyoma: cytologic-histologic study of 10 cases.
        Diagno Cytopathol. 2002; 27: 161-166
        • Lundgren L.
        • Seidal T.
        • Kindblom L.G.
        • Angervall L.
        Intermediate and fine filaments of vascular leiomyomas (angiomyoma), leiomyoma and leiomyosarcomas of large veins.
        APMIS. 1989; 97: 637-645
        • Botte M.J.
        • Silver M.A.
        Leiomyoma of a digital artery.
        Clin Orthop. 1990; 260: 259-262
        • Calle S.C.
        • Eaton R.G.
        • Littler J.W.
        Vascular leiomyoma in the hand.
        J Hand Surg. 1994; 19A: 281-286
        • Duinslaeger L.
        • Vierendeels T.
        • Wylock P.
        Vascular leiomyoma in the hand.
        J Hand Surg. 1987; 12A: 624-627
        • Hirata H.
        • Kusuzaki K.
        • Fukutome K.
        • Maeda M.
        • Uchida A.
        A hand mass that became painful 13 years after onset.
        Clin Orthop. 2005; 433: 265-270
        • Robinson S.C.
        • Kalish R.J.
        Leiomyoma in the hand: a case report.
        Clin Orthop. 1990; 225: 121-123
        • Yagi K.
        • Hamada Y.
        • Yasui N.
        (2006). A leiomyoma arising from the deep palmar arterial arch.
        J Hand Surg [Br]. 2006; 31B: 680-682
        • Huang K.C.
        • Lee K.F.
        Case report. Angioleiomyoma in the palm of an 11-year-old boy.
        Skeletal Radiol. 2008; 37: 339-341
        • Okten F.
        Vascular leiomyoma of the hand.
        Plast Reconstr Surg. 2005; 115: 1218-1219
        • Lawson G.M.
        • Salter D.M.
        • Hooper G.
        Angioleiomyoma of the hand. A report of 14 cases.
        J Hand Surg [Br]. 1995; 20: 479-483
        • Baran R.
        • Requena L.
        • Drapé J.L.
        Subungual angioleiomyoma masqueradind as a glomus tumor.
        Br J Dermatol. 2000; 142: 1239-1241
        • Requena L.
        • Baran R.
        Digital angioleiomyoma: an uncommon neoplasm.
        J Am Acad Dermatol. 1993; 29: 1043-1044
        • Gassel F.
        • Kraft C.N.
        • Wallny T.
        • Hess L.
        • Schmitt O.
        Case report. Soft tissue angioleiomyoma of the hand as a rare differential diagnosis of haemophilic pseudotumour.
        Haemophilia. 2001; 7: 528-531
        • Glowacki K.A.
        • Weiss A.P.C.
        Vascular leiomyoma of the finger causing bone erosion.
        Journal Hand Surg. 1995; 20A
        • Hauswald K.R.
        • Kasdan M.L.
        • Weiss D.L.
        Vascular leiomyoma of the hand: case report.
        Plast Reconstr Surg. 1975; 55: 89-91
        • Schoenborn A.
        • Maladry D.
        • Pelletier Le
        • Mitz V.
        Vascular leiomyoma in the hand. Report of a case and review of the literature concerning a rare pathology.
        Ann Chir PlastEsthet. 2002; 47: 651-655
        • Del Olmo J.
        • Marquina M.
        • Redondo P.
        Asymptomatic digital angioleiomyoma.
        Actas Dermosifiliogr. 2007; 98: 291-295
        • Sileo M.J.
        Digital angioleiomyoma: a case report and review of the literature.
        J Orthop. 2008; 5: e2
      3. Dramis A, Grimer RJ. Case report. Angioleiomyoma: a rare cause of fixed flexion contracture of the elbow. Sarcoma article ID 93569: 1–2, 2006

        • Murty A.N.
        • Ireland J.
        Angiomyoma of the patellar fat pad.
        Knee. 2000; 7: 253-254
        • Gassel F.
        • Sommer T.
        • Meyebehm M.
        • Schmitt O.
        Rare space occupying lesion of the knee joint.
        Radiologe. 1999; 39: 703-705
        • Sardanelli F.
        • Renzetti P.
        • Nardi F.
        • Cittadini G.
        • Tanara G.
        • Simoni G.
        Imaging of angioleiomyoma.
        J Clin Ultrasound. 1996; 24: 268-271
        • DiCaprio M.R.
        • Jokl P.
        Vascular leiomyoma presenting as medial joint line pain of the knee. Case report.
        Arthroscopy. 2003; 19: E24
        • Gulati M.S.
        • Kapoor A.
        • Maheshwari J.
        Angiomyoma of the knee joint: value of magnetic resonance imaging.
        Australas Radiol. 1999; 43: 353-354
        • Okahashi K.
        • Sugimoto K.
        • Iwai M.
        • Oshima M.
        • Takakura Y.
        Intra-articular angioleiomyoma of the knee: a case report.
        Knee. 2006; 13: 330-332
        • Lee S.K.
        • Arbini A.A.
        • Galloway M.T.
        Angioleiomyoma of the patellar tendon sheath.
        Am J Knee Surg. 2001; 14: 178-180
        • Gatti J.
        • Morvan G.
        • Henin D.
        • Aboulker J.
        • Nahum H.
        • Glowinski J.
        Leiomyomatosis metastasizing to the spine. A case report.
        J Bone Joint Surg Am. 1983; 65: 1163-1165
        • Liang H.
        • Frederiksen N.
        • Binnie W.
        • Cheng Y.
        Intraosseous oral leiomyoma: systematic review and report of one case.
        Dentomaxillofac Radiol. 2003; 32: 285-290
        • Vaillo-Vinagre A.
        • Ballestin-Carcavilla C.
        • Madero-Garcia S.
        • Pastor-Garcia S.
        • Checa-Garcia A.
        • Martinez-Tello F.
        Primary angioleiomyoma of the iliac bone: clinical pathology study of one case with flow cytometric DNA content and S-phase fraction analysis.
        Skeletal Radiol. 2000; 29: 181-185
        • Jeung C.
        • Song S.
        • Kim S.
        • Song K.
        Primary leiomyoma of the temporal bone.
        J Korean Neurosurg Soc. 2004; 35: 321-323
        • Tomoda K.
        • Iyama K.
        A case of intraosseous angioleiomyoma.
        Acta Orthop Scand. 1992; 63: 568-570
        • Laffosse J.M.
        • Gomez-Brouchet A.
        • Giordano G.
        • Bonnevialle N.
        • Puget J.
        Intraosseous leiomyoma: a report of two cases. Case report.
        Joint Bone Spine. 2007; 74: 389-392
        • Braun W.
        • Kotter A.
        • Kundel K.
        • Wiedemann M.
        • Wagner T.
        Intraosseous leiomyoma of the neck of the femur. A case report.
        Int Orthop. 1994; 18: 47-49
        • Zikria B.
        • Radevic M.
        • Jormark S.
        • Huvos A.
        • Yang S.
        Intraosseous leiomyoma of the ulna. A case report.
        J Bone Joint Surg Am. 2004; 86-A: 2522-2525
        • Cancilleri F.
        • Ippolito M.
        • Amato C.
        • Denaro V.
        Tarsal tunnel syndrome: four uncommon cases.
        Foot Ankle Surg. 2007; 13: 214-217
        • Santucci A.
        • Albini M.
        • Ventura A.
        • De Palma L.
        Clinical and histological features of vascular leiomyoma of the foot: case report and literature review.
        Foot Ankle Surg. 2000; 6: 267-274
        • Habershaw G.H.
        • Hurchik J.M.
        • Hasser I.
        Pedal leiomyoma.
        J Foot Ankle Surg. 1994; 33: 260-265
      4. Barnes SJ, Van Pettius DG, Maffulli N. Angioleiomyoma of the Achilles tendon. Bull Hos Jt Dis 61(3, 4): 2003–2004.

        • Sonohata M.
        • Okamoto T.
        • Shigematsu M.
        • Mawatari M.
        • Hotokebuchi T.
        Angioleiomyoma overlying the Achilles tendon.
        J Orthop Sci. 2007; 12: 502-504
        • Murata H.
        • Matsui T.
        • Horie N.
        • et al.
        Angioleiomyoma with calcification of the heel: report of two cases.
        Foot Ankle Int. 2007; 28: 1021-1025
        • Smith J.
        • Wisniewski S.J.
        • Lee R.A.
        Sonographic and clinical features of angioleiomyoma presenting as painful Achilles tendon mass.
        J Ultrasound Med. 2006; 25: 1365-1368