Extremity angioleiomyomas: A comprehensive review of 41 cases

Objectives: Angioleiomyomas (ALMs) are rare, benign smooth muscle tumors originating from blood vessels. Existing literature on ALMs is limited to short case series. Larger studies lack either radiological or histopathological data, as well as long-term follow-up. This retrospective cohort study of 41 peripheral ALM cases, confirmed by ultrasound scan (USS)-guided biopsy or excisional pathology, aimed to provide a comprehensive review of ALM patients from a single center between December 2009 and September 2023. Methods: This is a retrospective cohort study of 41 imaging- or pathology-confirmed ALM cases. Electronic records were used to obtain patient data, including demographics; lesion location and size; symptoms; histology; radiology; management; a minimum 1-year follow-up; and time to intervention. Results: Most ALMs in this patient cohort were in the lower limb (32, or 78.04%); 21 (51.21%) were in the foot and ankle, followed by 6 (14.63%) in the hand and wrist. The average value of the largest lesion measurement from imaging (magnetic resonance imaging or USS) was 19.9 mm (standard deviation = 8.68). About 58.53% of patients presented with pain, and 10 (24.39%) reported functional changes (impaired range of motion/grip strength). There was no significant relationship between lesion size and the presence of pain ( p = 0.564). Thirty-two (78.05%) patients received surgical intervention. All surgically managed patients returned to baseline with no cases of local recurrence. Of the 9 (21.95%) patients managed conservatively, 2 (22.22%) returned for surgical intervention. Conclusion: This study demonstrates the safety of surgical management of peripheral ALMs regardless of size and location. Surgical management showed positive outcomes with symptomatic relief and no long-term complications.