Vascular Leiomyoma of the Foot: Ultrasound and Histologic Correlation

Abstract

Fig. 1. (A) Specimen obtained by surgical resection. (B) Grayscale ultrasound of the longitudinal axis of the lesion, showing defined edges, with alternating anechoic We present the case of a 39-year-old woman with an egghaped tumor on the lateral aspect of her right ankle below the ateral malleolus, measuring 3.2 cm. The lesion was detected by he patient 3 years before she came to the clinic; however, it prouced pain when walking only a year before her visit. The tumor as painful on palpation and had a hard consistency (Fig. 1A). n ultrasound with Esaote MyLab 25® equipment and a multifreuency linear transducer of 10–18 MHz, was used; we found an val image with anechoic areas within it alternating with isoehoic regions (Fig. 1B). The lesion could not be compressed with he transducer and, with the application of power Doppler, vascuarity was positive (Fig. 1C). The patient underwent surgery with omplete removal of the lesion without complications. The histoogical study showed a benign mesenchymal neoplasm composed f smooth muscle bundles arranged in a disorganized way, with xtensive areas of hyalinization and vascular thickening, changes onsistent with the diagnosis of leiomyoma (Fig. 1D). Leiomyomas arising outside of the uterus and the gastroinestinal tract are rare. These benign neoplasms of smooth muscle ave been reported mainly in the lower limbs and feet of women etween the third and fifth decade of life.1 The angioleiomyoma r vascular leiomyoma originates from the tunica media of small eins or arteries.2,3 Leiomyomas were divided into 3 groups: cutaeous, soft tissue (angioleiomyomas) or deep retroperitoneal or on he extremities. The differential diagnosis of this neoplasm includes ipomas, hemangiomas, rheumatoid nodules, ganglia, schwannoas, neurofibromas, desmoid tumors and pigmented villonodular ynovitis (giant cell tumor of the tendon sheath). Although there are escriptions made by MRI and sonography.4,5 of the leiomyomas,