Angioleiomyoma of the Lower Lip

Abstract

Leiomyoma is a benign smooth muscle tumor that occurs most frequently in the uterine myometrium, gastrointestinal tract, skin, and lower extremities. Leiomyoma rarely affects the oral cavity. Angioleiomyoma (vascular leiomyoma) is a histological subtype of the leiomyoma. The diagnosis is commonly determined by histopathological studies. This case report shows a 57-year-old male patient with a lesion of the lower lip. After laser excision, hematoxylin and eosin and smooth muscle actin staining confirmed the diagnosis of angioleiomyoma.

Clinical, Imaging and Histopathology of Angioleiomyoma of the Buccal Cheek

“…In conclusion, we have reported a case of angioleiomyoma of the buccal cheek that resulted in a good outcome. Among various studies, the most common sites of oral angiomyomas were the lip [2,4,[12][13][14][15]32], cheek or buccal mucosa [5,8,14,[16][17][18], palate [7,[19][20][21], tongue [6,22,23], and submandibular area [9,11,24]. Other areas such as the gingiva, mandible, retromolar area, and anterior maxillary labial fold were only reported once among studies [2,10,17].…”

“…Having numerous blood vessels may pretend other benign vascular tumors such as hemangioma, hemangiopericytoma, hemangioendothelioma, vascular malformation, and other neurovascular hamartomas [ 29 ], but a definite examination could rule out these lesions because of the smooth muscle background. Immunohistochemically markers like SMA and MSA (muscle-specific actin) can be useful in identification of smooth muscle nature of the cellular stroma [ 15 , 30 , 31 ]. In the present study, IHC staining was positive for both desmin and SMA.…”

The Sinewy Swirls- Angioleiomyoma

“…Angioleiomyoma emerging as a painful nodule requires segregation from glomus tumour, traumatic neuroma, eccrine spiradenoma or angiolipoma. Tumours confined to the extremity mandate distinction from a ganglion cyst, neuroma, fibroma, lipoma, neurofibroma, neurilemmoma or an inclusion cyst [7,9]. Angioleiomyoma requires a clinical demarcation from mesenchymal neoplasms such as leiomyosarcoma, salivary gland neoplasms as the mucocoele or pleomorphic adenoma, vascular neoplasms as lymphangioma, haemangioma or pyogenic granuloma along with soft tissue cysts as dermoid cyst [7,9].…”

“…Tumours confined to the extremity mandate distinction from a ganglion cyst, neuroma, fibroma, lipoma, neurofibroma, neurilemmoma or an inclusion cyst [7,9]. Angioleiomyoma requires a clinical demarcation from mesenchymal neoplasms such as leiomyosarcoma, salivary gland neoplasms as the mucocoele or pleomorphic adenoma, vascular neoplasms as lymphangioma, haemangioma or pyogenic granuloma along with soft tissue cysts as dermoid cyst [7,9]. Angioleiomyoma situated within the hard palate or lesions adjacent to the teeth necessitate distinction from a periodontal lesion [7,9].…”

“…Angioleiomyoma requires a clinical demarcation from mesenchymal neoplasms such as leiomyosarcoma, salivary gland neoplasms as the mucocoele or pleomorphic adenoma, vascular neoplasms as lymphangioma, haemangioma or pyogenic granuloma along with soft tissue cysts as dermoid cyst [7,9]. Angioleiomyoma situated within the hard palate or lesions adjacent to the teeth necessitate distinction from a periodontal lesion [7,9]. Investigative assay: Ultrasonography depicts a well defined, minimally echoic, hyper-vascular tumour nodule with a distinctive tumour perimeter and homogenous intrinsic architecture, indicative of a benign neoplasm.Magnetic resonance imaging (MRI) features are non specific.…”