Angioleiomyomas in the head and neck: A retrospective clinical and immunohistochemical analysis

Abstract

Angioleiomyoma is a benign soft-tissue tumor originating from vascular smooth muscle, and is rare in the head and neck. The present study retrospectively examined a cohort of patients with head and neck angioleiomyoma treated at the West China Hospital of Stomatology, and also subjected archived tissues to modern immunohistochemical analysis. In total, 21 patients were treated for angioleiomyoma between 1978 and 2012 at the West China Hospital of Stomatology, Sichuan University (Chengdu, Sichuan, China). Medical records were examined and paraffin block sections were cut and stained with hematoxylin and eosin, Masson’s trichrome stain and Van Gieson stain, prior to being subjected to immunohistochemical analysis to re-evaluate and confirm the diagnoses. Angioleiomyomas were found to account for only 0.18% of the benign head and neck tumors in the patients presenting to the hospital over the past 34 years. The diagnosis was more common in males (male:female ratio, 1.625:1) and the mean age at diagnosis was 42.5 years. The most common sites were the buccal mucosa, parotid gland and palate. More than half of the tumors (61.9%) were >2 cm in diameter. Five tumors presented with pain and/or tenderness. The histological subtype was reported as solid in five cases, venous in six, cavernous in nine and venous-cavernous in one. Three tumors exhibited nerve neurofibrils. All tumors were excised with no subsequent recurrence. Cytological and imaging examinations were not useful for pre-operative diagnosis. Angioleiomyoma is a benign tumor that causes limited morbidity. Surgical excision is the only effective treatment and recurrence is rare. The present study revealed that nerves were present in a small proportion (14.3%) of tumors. It was hypothesized that the compression of nerves accompanying numerous blood vessels in the tumor may cause pain, particularly in venous- and cavernous-type angioleiomyomas.

Angioleiomyoma of the Sinonasal Tract: Analysis of 16 Cases and Review of the Literature

“…ALMs originating from sinonasal mucosa-covered sites are even rarer. They represented 9.5-12.5 % of head and neck and 1 % of all ALMs, respectively [7,8,27]. Only a single case of ALM was identified among 331 consecutive benign sinonasal masses (0.3 %) [42].…”

“…Head and neck angioleiomyoma (ALM) are rare, comprising 8.5 and 13 % of all ALMs in two larger series [7,8]. ALMs originating from sinonasal mucosa-covered sites are even rarer.…”

“…The latter may consist of thick-walled collapsed vascular channels (solid type), predominant thick-walled venous vessels with well recognizable lumens within smooth muscle background (venous type), or display ectatic muscular venous channels mimicking venous hemangioma but with variable smooth muscle component in-between (cavernous type) [6]. The majority of lesions originate in the extremities (*90 %), mainly in the lower limbs while ALM of the head and neck region is uncommon (*10 %) [7,8]. Submucosal ALMs of the sinonasal tract are exceptionally rare.…”

Soft Tissue Special Issue: Perivascular and Vascular Tumors of the Head and Neck

“…Mitotic figures are usually absent. Nuclear atypia, myxoid changes, calcification, ossification and fatty metaplasia can be present in longstanding regressive lesions [7][8][9][10]. One peculiar angioleiomyoma in the lymph node hilus usually occurs in the neck [10].…”

Expression of estrogen and progesterone receptors in angioleiomyoma of the nasal cavity of six patients

“…CT and MRI are the most common imaging methods used for the examination of nasal tumors (3,36), while angiography is only employed in rare cases (24,37). There were no specific features observed during imaging in the present study, but post-contrast images were easily misdiagnosed pre-operatively as hemangioma.…”