Images in Clinical Rheumatology
Vascular Leiomyoma of the Foot: Ultrasound and Histologic Correlation
Leiomioma vascular en el pie: correlación ecográfica e histológica
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(B) Grayscale ultrasound of the longitudinal axis of the lesion, showing defined edges, with alternating anechoic and isoechoic areas. (C) Positivity of the power Doppler signal (vascularity). (D) Histological section (hematoxylin–eosin) showing disorganized bundles of spindle cells (smooth muscle) and vascular thickening.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 39-year-old woman with an egg-shaped tumor on the lateral aspect of her right ankle below the lateral malleolus, measuring 3.2<span class="elsevierStyleHsp" style=""></span>cm. The lesion was detected by the patient 3 years before she came to the clinic; however, it produced pain when walking only a year before her visit. The tumor was painful on palpation and had a hard consistency (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). An ultrasound with Esaote MyLab 25<span class="elsevierStyleSup">®</span> equipment and a multifrequency linear transducer of 10–18<span class="elsevierStyleHsp" style=""></span>MHz, was used; we found an oval image with anechoic areas within it alternating with isoechoic regions (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). The lesion could not be compressed with the transducer and, with the application of power Doppler, vascularity was positive (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). The patient underwent surgery with complete removal of the lesion without complications. The histological study showed a benign mesenchymal neoplasm composed of smooth muscle bundles arranged in a disorganized way, with extensive areas of hyalinization and vascular thickening, changes consistent with the diagnosis of leiomyoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>D).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Leiomyomas arising outside of the uterus and the gastrointestinal tract are rare. These benign neoplasms of smooth muscle have been reported mainly in the lower limbs and feet of women between the third and fifth decade of life.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The angioleiomyoma or vascular leiomyoma originates from the tunica media of small veins or arteries.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Leiomyomas were divided into 3 groups: cutaneous, soft tissue (angioleiomyomas) or deep retroperitoneal or on the extremities. The differential diagnosis of this neoplasm includes lipomas, hemangiomas, rheumatoid nodules, ganglia, schwannomas, neurofibromas, desmoid tumors and pigmented villonodular synovitis (giant cell tumor of the tendon sheath). Although there are descriptions made by MRI and sonography.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> of the leiomyomas, an excisional biopsy to confirm the diagnosis is required.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Treatment consists of complete resection of the lesion.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Ethical Responsibilities</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Protection of people and animals</span><p id="par0015" class="elsevierStylePara elsevierViewall">The authors declare that no experiments have been performed on humans or animals.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Data confidentiality</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors state that no patient data appear in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Right to privacy and informed consent</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors state that no patient data appear in this article.</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflict of Interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical Responsibilities" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Protection of people and animals" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Data confidentiality" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Right to privacy and informed consent" ] ] ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of Interest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Chávez-López M, Reyna-Olivera G, Pedroza-Herrera G. Leiomioma vascular en el pie: correlación ecográfica e histológica. Reumatol Clin. 2013;10:342–343.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 577 "Ancho" => 1001 "Tamanyo" => 118127 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Specimen obtained by surgical resection. (B) Grayscale ultrasound of the longitudinal axis of the lesion, showing defined edges, with alternating anechoic and isoechoic areas. (C) Positivity of the power Doppler signal (vascularity). (D) Histological section (hematoxylin–eosin) showing disorganized bundles of spindle cells (smooth muscle) and vascular thickening.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leiomyoma of the foot: sonographic features with pathologic correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Stock" 1 => "G. Perino" 2 => "E. Athanasian" 3 => "R. Adler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11420-010-9190-z" "Revista" => array:6 [ "tituloSerie" => "HSS J" "fecha" => "2011" "volumen" => "7" "paginaInicial" => "94" "paginaFinal" => "98" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22294965" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vascular leiomyoma of foot" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Gajanthodi" 1 => "R. Rai" 2 => "R.K. Chaudhry" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7860/JCDR/2013/4457.2829" "Revista" => array:6 [ "tituloSerie" => "J Clin Diagn Res" "fecha" => "2013" "volumen" => "7" "paginaInicial" => "571" "paginaFinal" => "572" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23634427" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Plantar heel pain due to vascular leiomyoma (angioleiomyoma)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.H. Cheung" 1 => "T.H. Lui" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1938640012457677" "Revista" => array:6 [ "tituloSerie" => "Foot Ankle Spec" "fecha" => "2012" "volumen" => "5" "paginaInicial" => "321" "paginaFinal" => "323" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22935412" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Soft tissue masses in the foot and ankle: characteristics on MR imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. Woertler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2005-921942" "Revista" => array:6 [ "tituloSerie" => "Semin Musculoskelet Radiol" "fecha" => "2005" "volumen" => "9" "paginaInicial" => "227" "paginaFinal" => "242" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16247723" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angiomyoma of the lower extremity: MR findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "T. Kinoshita" 1 => "K. Ishii" 2 => "Y. Abe" 3 => "H. Naganuma" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "1997" "volumen" => "26" "paginaInicial" => "443" "paginaFinal" => "445" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9259106" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001000000005/v1_201409070108/S2173574313001445/v1_201409070108/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001000000005/v1_201409070108/S2173574313001445/v1_201409070108/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574313001445?idApp=UINPBA00004M" ]
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| 2023 January | 25 | 21 | 46 |
| 2022 December | 40 | 37 | 77 |
| 2022 November | 46 | 37 | 83 |
| 2022 October | 53 | 42 | 95 |
| 2022 September | 27 | 25 | 52 |
| 2022 August | 27 | 45 | 72 |
| 2022 July | 33 | 36 | 69 |
| 2022 June | 32 | 29 | 61 |
| 2022 May | 39 | 40 | 79 |
| 2022 April | 34 | 44 | 78 |
| 2022 March | 28 | 47 | 75 |
| 2022 February | 32 | 37 | 69 |
| 2022 January | 20 | 34 | 54 |
| 2021 December | 19 | 38 | 57 |
| 2021 November | 35 | 51 | 86 |
| 2021 October | 50 | 49 | 99 |
| 2021 September | 44 | 38 | 82 |
| 2021 August | 36 | 38 | 74 |
| 2021 July | 41 | 37 | 78 |
| 2021 June | 40 | 33 | 73 |
| 2021 May | 28 | 36 | 64 |
| 2021 April | 50 | 66 | 116 |
| 2021 March | 54 | 24 | 78 |
| 2021 February | 46 | 16 | 62 |
| 2021 January | 42 | 16 | 58 |
| 2020 December | 31 | 17 | 48 |
| 2020 November | 28 | 19 | 47 |
| 2020 October | 19 | 15 | 34 |
| 2020 September | 35 | 24 | 59 |
| 2020 August | 28 | 19 | 47 |
| 2020 July | 17 | 12 | 29 |
| 2020 June | 23 | 19 | 42 |
| 2020 May | 38 | 12 | 50 |
| 2020 April | 21 | 21 | 42 |
| 2020 March | 13 | 9 | 22 |
| 2020 February | 2 | 0 | 2 |
| 2018 May | 5 | 0 | 5 |
| 2018 April | 76 | 7 | 83 |
| 2018 March | 91 | 10 | 101 |
| 2018 February | 43 | 3 | 46 |
| 2018 January | 57 | 5 | 62 |
| 2017 December | 37 | 7 | 44 |
| 2017 November | 49 | 5 | 54 |
| 2017 October | 31 | 5 | 36 |
| 2017 September | 48 | 10 | 58 |
| 2017 August | 28 | 13 | 41 |
| 2017 July | 42 | 10 | 52 |
| 2017 June | 68 | 7 | 75 |
| 2017 May | 69 | 15 | 84 |
| 2017 April | 61 | 6 | 67 |
| 2017 March | 52 | 19 | 71 |
| 2017 February | 38 | 6 | 44 |
| 2017 January | 43 | 20 | 63 |
| 2016 December | 69 | 15 | 84 |
| 2016 November | 55 | 7 | 62 |
| 2016 October | 77 | 10 | 87 |
| 2016 September | 137 | 7 | 144 |
| 2016 August | 69 | 15 | 84 |
| 2016 July | 38 | 12 | 50 |
| 2015 December | 2 | 0 | 2 |
| 2015 August | 4 | 0 | 4 |
| 2015 July | 21 | 7 | 28 |
| 2015 June | 48 | 9 | 57 |
| 2015 May | 55 | 13 | 68 |
| 2015 April | 39 | 8 | 47 |
| 2015 March | 42 | 9 | 51 |
| 2015 February | 49 | 6 | 55 |
| 2015 January | 56 | 12 | 68 |
| 2014 December | 55 | 13 | 68 |
| 2014 November | 47 | 6 | 53 |
| 2014 October | 55 | 15 | 70 |
| 2014 September | 24 | 14 | 38 |
Show all
