Concurrent uterine and pelvic angiolipoleiomyomas

Angiolipoleiomyomas (ALLMs) are benign mesenchymal tumours composed of vascular, muscular and adipocytic components. Very few cases have been described in the female reproductive tract. We present a case of concurrent ALLMs in the cervix associated with another apparently independent ALLM in the pararectal region. The lesions were incidentally detected on imaging and were surgically resected. Histopathology showed well-circumscribed, non-encapsulated tumours with no atypia or mitotic activity. Immunohistochemistry was positive for smooth muscle markers and negative for melanocytic and stromal markers, supporting a diagnosis of ALLM. The patient recovered well postoperatively with no recurrence at 26 months of follow-up. This case adds to the limited literature on ALLM and highlights two previously unreported features: pseudoinfiltrative margins and prominent nerve bundles. Demonstrating that such features may occur in ALLM despite its benign behaviour is important to avoid misdiagnosis and unnecessary aggressive management.