Ortiz Wendolin J, Eager John J, Cervantes Mario
General Surgery, Universidad Autónoma de Baja California, Mexicali, MEX.
Pathology, Hospital Corporation of America (HCA) Houston Healthcare West, Houston, USA.
Cureus. 2023 Mar 11;15(3):e36016. doi: 10.7759/cureus.36016. eCollection 2023 Mar.
We present a case series of two rare cases of angioleiomyoma of the hand, an infrequent type of benign tumor. In the first case, a 41-year-old female presented with a left thumb mass that had increased in size over two years. Imaging studies revealed a destructive lesion involving the first webspace with infiltration of the first metacarpal, and the mass was initially suspected to be a sarcoma. However, a percutaneous image-guided fine-needle aspiration (US-FNA) and ultrasound-guided core-needle biopsy (USG-CNB) of the left-hand mass confirmed the diagnosis of angioleiomyoma. The mass was surgically excised, and the final diagnosis was consistent with the earlier USG-CNB. In the second case, a 63-year-old man with end-stage renal disease presented for consultation regarding dialysis access creation. During the examination, a large, soft, mobile mass adjacent to the wrist on the medial aspect of his hand was identified. This was presumed to be a lipoma. However, the histopathology report revealed a benign angioleiomyoma measuring 3.2 cm, which had been completely excised during the surgery. This case report highlights the importance of considering angioleiomyoma in the differential diagnosis of soft tissue masses and the utility of US-FNA and USG-CNB in diagnosing these tumors.
我们报告了两例手部血管平滑肌瘤的罕见病例系列，血管平滑肌瘤是一种不常见的良性肿瘤类型。第一例中，一名41岁女性，左手拇指肿物，两年内逐渐增大。影像学检查显示第一掌骨间隙有破坏性病变并累及第一掌骨，该肿物最初怀疑为肉瘤。然而，对左手肿物进行的经皮影像引导下细针穿刺抽吸活检（US-FNA）和超声引导下粗针穿刺活检（USG-CNB）确诊为血管平滑肌瘤。该肿物经手术切除，最终诊断与早期USG-CNB结果一致。第二例中，一名患有终末期肾病的63岁男性前来咨询建立透析通路的问题。检查时，在其手部内侧腕关节旁发现一个大的、柔软的、可移动的肿物。起初推测为脂肪瘤。然而，组织病理学报告显示为一个3.2厘米的良性血管平滑肌瘤，手术中已将其完整切除。本病例报告强调了在软组织肿物鉴别诊断中考虑血管平滑肌瘤的重要性，以及US-FNA和USG-CNB在诊断这些肿瘤中的实用性。
