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Case Report Plastic and Aesthetic Research

Angioleiomyoma: a rare diagnosis of a

painful subcutaneous nodule in the hand

Sandeep Bhogesha , Satyaswarup Tripathy , Jerry R. John , Debajyoti Chatterjee 2
1
1
1
1 Department of Plastic Surgery, Post graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
2 Department of Pathology, Post graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India.
Address for correspondence: Dr. Satyaswarup Tripathy, Department of Plastic Surgery, Post graduate Institute of Medical Education
and Research, Sector 12, Chandigarh 160012, India. E-mail: dr.sstripathy@gmail.com

ABSTRACT
Angioleiomyoma of the hand is a rare differential diagnosis of painful soft tissue nodule in the
extremity. It arises from smooth muscle of the blood vessels and the most common symptom is
pain. Imaging with magnetic resonance imaging shows characteristic features like a hypodense
peripheral capsule with linear or branching internal hyperdensities on T2-weighted images,
and post-contrast diffuse homogenous enhancement with a vessel leading up to the lesion.
Histopathological examination shows well circumscribed fascicles of mature smooth muscle cells
surrounding vascular lumina, lined by normal appearing endothelium without elastic lamina
present. These cells stain positive for smooth muscle actin, desmin, vimentin, type IV collagen and
S100, but stain negative for HMB-45 and ER. Angioleiomyoma is amenable for surgical resection.
We report a case of painful subcutaneous nodule of hand, with radiological and histopathological
findings suggestive of angioleiomyoma. We outline the clinical, radiological and histopathological
features of this rare diagnosis for painful nodule of extremity.

Key words:
Hand; tumor; angioleiomyoma; histopathology; excision; biopsy

Dr. Sandeep Bhogesha is Senior Resi- Dr. Satyaswarup Tripathy is Associate
dent in Plastic Surgery in PGIMER, Professor in Plastic Surgery in PGIMER,
Chandigarh, India. His research interests Chandigarh, India. He specializes in
include outcomes of nerve pathologies in brachial plexus surgeries. His areas of
the upper limb and craniofacial surgery. interest include tumours of the upper limb.

Dr. Jerry R. John is Assistant Professor in Dr. Debajyoti Chatterjee is a histopatho-
Plastic Surgery in PGIMER, Chandigarh, logist, specialized in neuropathology. His
India. He is a reconstructive microsurgeon. areas of interests include neuropathology,
His areas of interest include trauma, burn dermatopathology, soft tissue and breast
and onco-reconstruction; perforator flaps pathology.
and outcome research in lower limb trauma.

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How to cite this article: Bhogesha S, Tripathy S, John JR, Chatterjee
DOI: D. Angioleiomyoma: a rare diagnosis of a painful subcutaneous nodule
10.20517/2347-9264.2015.86 in the hand. Plast Aesthet Res 2016;3:126-8
Received: 14-08-2015; Accepted: 17-11-2015
126 © 2016 Plastic and Aesthetic Research | Published by OAE Publishing Inc.