Page 137 - Read Online

Figure 1: Preoperative picture. Note the bulge over the thenar eminence

Figure 4: Gross cut section

Figure 5: (a) Photomicrographs showing a tumor composed of bundles
Figure 2: MRI showing well defined lesion in the thenar area. MRI: of smooth muscles with intervening blood vessels (HE, ×100); (b)
magnetic resonance imaging higher magnification showing bland nature of the smooth muscles
and intervening thick muscular blood vessel (HE, ×200); (c) the tumor
cells show strong positivity for smooth muscle actin (IP, ×100)
common presenting complaint is pain. Since this lesion is a
rare occurrence and the list of differential diagnoses for painful
mobile subcutaneous mass is extensive, a case report and
literature review of angioleiomyoma is presented.

CASE REPORT

A 36-year-old man presented with a 2-year history of a slow-
growing, mildly painful mass in the palmar aspect of the thenar
eminence of the right hand. There was no history of trauma. On
examination, a 3 cm × 2 cm firm, mobile mass was palpated on
the thenar eminence of the right hand. The lesion did not extend
to the underlying bone and tendon. The overlying skin could be
easily pinched from the lesion and did not show ulceration or
discoloration. Temperature and sensation of the overlying skin
Figure 3: Intraoperative view showing a blood vessel from the palmar was normal. Thus, a clinical diagnosis of soft tissue tumor was
arch in close proximity to the tumor made [Figure 1].
INTRODUCTION Magnetic resonance imaging (MRI) of the hand revealed a
well-defined 2.5 cm × 2.8 cm lesion in the first web space of
Angioleiomyoma is a unique form of soft tissue tumor, the right hand infiltrating adjacent musculature. The lesion was
which arises from the smooth muscle of blood vessels. This heterogeneously hyperdense on T2, and isodense on T1. Prominent
[1]
tumor can appear in different parts of the body, and the most feeders were seen from arterial branches of the palmar arch. No
Plast Aesthet Res || Volume 3 || April 25, 2016 127