Angioleiomyoma (vascular leiomyoma, angiomyoma) of the skin is thought to arise from

vascular smooth muscle Vascular smooth muscle is the type of smooth muscle that makes up most of the walls of blood vessels. Structure Vascular smooth muscle refers to the particular type of smooth muscle found within, and composing the majority of the wall of blood v ...

, and is generally

acquired ''Acquired'' is a podcast by Ben Gilbert and David Rosenthal about business history and strategy. As of 2024, the podcast has more than 600,000 monthly listeners. History Gilbert and Rosenthal worked together at Madrona Venture Group and ini ...

.Freedberg, et al. (2003). ''Fitzpatrick's Dermatology in General Medicine''. (6th ed.). Page 1033. McGraw-Hill. . Angioleiomyomas appear as small (<2 cm), firm, movable, slow growing subcutaneous

nodules Nodule may refer to: *Nodule (geology), a small rock or mineral cluster *Manganese nodule, a metallic concretion found on the seafloor *Nodule (medicine), a small aggregation of cells *Root nodule Root nodules are found on the roots of plants, p ...

. Pain is a common symptom. They are most commonly seen on the extremities. The cause of angioleiomyoma is unknown.

Signs and symptoms

Angioleiomyomas present as solitary, small, slow-growing, firm, movable, subcutaneous

that typically measure less than 2 cm in size. Pain is the most obvious symptom of angioleiomyomas. Wind and cold exposure can set off paroxysmal episodes of pain. It is believed to be caused by

smooth muscle Smooth muscle is one of the three major types of vertebrate muscle tissue, the others being skeletal and cardiac muscle. It can also be found in invertebrates and is controlled by the autonomic nervous system. It is non- striated, so-called bec ...

contractions that are active and cause localized

ischemia Ischemia or ischaemia is a restriction in blood supply to any tissue, muscle group, or organ of the body, causing a shortage of oxygen that is needed for cellular metabolism (to keep tissue alive). Ischemia is generally caused by problems ...

. It seems that rest is a relieving aspect. Although this tumor can develop anywhere in the body, it usually first appears in the extremities, then the head and trunk. The lesion is usually located in the subcutis, however it can also appear in the

dermis The dermis or corium is a layer of skin between the epidermis (skin), epidermis (with which it makes up the cutis (anatomy), cutis) and subcutaneous tissues, that primarily consists of dense irregular connective tissue and cushions the body from s ...

Causes

The exact etiology of angioleiomyomas is yet unknown. Aetiological aspects that have been suggested include minor trauma,

venous stasis Venous stasis, or venostasis, is a condition of slow blood flow in the veins, usually of the legs. Presentation Complications Potential complications of venous stasis are: * Venous ulcers * Blood clot formation in veins (venous thrombosis), tha ...

, and hormonal alterations, particularly those related to

estrogen Estrogen (also spelled oestrogen in British English; see spelling differences) is a category of sex hormone responsible for the development and regulation of the female reproductive system and secondary sex characteristics. There are three ...

. The

idea is supported by the observation of chronic

inflammatory cell White blood cells (scientific name leukocytes), also called immune cells or immunocytes, are cells of the immune system that are involved in protecting the body against both infectious disease and foreign entities. White blood cells are general ...

infiltrates in certain lesions. Angioleiomyomas have been linked to Epstein-Barr virus (EBV) infection in

immunocompromised Immunodeficiency, also known as immunocompromise, is a state in which the immune system's ability to fight infectious diseases and cancer is compromised or entirely absent. Most cases are acquired ("secondary") due to extrinsic factors that affe ...

patients.

Diagnosis

Histologically, angioleiomyomas have a unique pattern with several tiny vascular gaps surrounded by bundles of spindle-shaped

cells. Angioleiomyoma appears to be benign on

ultrasonography Medical ultrasound includes diagnostic techniques (mainly imaging) using ultrasound, as well as therapeutic applications of ultrasound. In diagnosis, it is used to create an image of internal body structures such as tendons, muscles, joints, ...

, with well-defined boundaries and a homogenous shape. High resistance in intratumour arteries is revealed by a color

Doppler The Doppler effect (also Doppler shift) is the change in the frequency of a wave in relation to an observer who is moving relative to the source of the wave. The ''Doppler effect'' is named after the physicist Christian Doppler, who described ...

examination, indicating the existence of muscle arteries.

Treatment

Angioleiomyoma are treated by surgical excisision.

Epidemiology

Angioleiomyomas make around 5% of all benign soft tissue neoplasms. They primarily afflict people in their third and fifth decades of life, and they are more common in women than in men.

References

External links

DermNet

{{Soft tissue tumors and sarcomas Dermal and subcutaneous growths