Giant angioleiomyoma in extremity: report of two cases

Angioleiomyomas are smooth muscle tumors that occur most often in the extremities and are usually less than 2 cm in diameter. We present 2 case reports of giant angioleiomyoma. Case 1 was a 51-year-old woman with a 5-year history of a slowly growing mass 12x10 cm in diameter in the right posterior thigh. The tumor was larger than any previously reported. Case 2 was a 72-year-old man with an 8-year history of a slowly growing mass 6x6 cm in diameter in the left palm. The tumor was unique in that it grew to a giant size in the hand of the elderly patient. Magnetic resonance imaging of both cases confirmed the tumors' presence in the subcutis. T1-weighted images showed homogenous signal isointense to muscle. On T2-weighted images, areas of hyperintensity and hypointensity intermingled. Three-dimensional gadolinium-enhanced magnetic resonance angiography showed rapid initial enhancement followed by a gradual increase in enhancement, suggesting that the tumors were rich in vessels. Microscopic examination revealed numerous vascular channels embedded within a huge smooth muscle component.