Angiomyoma of the patellar fat pad.
We report a case of solitary angiomyoma arising in the infra-patellar fat pad and presenting with anterior knee pain.
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We report a case of solitary angiomyoma arising in the infra-patellar fat pad and presenting with anterior knee pain.
The expression of fine and intermediate filaments in 10 cases of leiomyosarcoma originating from a large vein, 9 cases of vascular leiomyoma (angiomyoma) and one case of a leiomyoma originating from the wall of the saphena magna vein was studied immunohistochemically by using 6 different anti-desmin antibodies, one anti-vimentin antibody and 2 antibodies to muscle-specific isoforms of actin. All the benign tumors and all the leiomyosarcomas of a large vein as well as the vein of origin were positively stained for desmin. The staining results obtained using the different anti-desmin antibodies varied considerably, however, and formaldehyde-fixed tissues were apparently inappropriate for some of them. No single anti-desmin antibody produced a positivity in all cases, and the extent and distribution of the positivity varied by being irregular and patchy in the leiomyosarcomas and in the muscle walls of the veins, while the benign tumors generally revealed a more uniform and strong positivity. Antibodies to muscle-specific and smooth muscle-specific actin produced a positive staining in all the benign tumors, as well as all the leiomyosarcomas and the veins from which they originated. A strong and uniform positivity was observed in the benign tumors and muscle walls of the veins, while the positivity in the leiomyosarcomas was more irregular, as it was for desmin. Vimentin was constantly expressed in the benign tumors and in the veins of origin, but only in 5/10 of the leiomyosarcomas. It is concluded from this study that the immunohistochemical demonstration of desmin, utilizing a monoclonal antibody appropriate to the type of fixation used, and muscle specific isoforms of actin, provide strong support to the light-microscopic diagnosis of leiomyosarcoma of venous origin.
Two cases of laryngeal angiomyoma which developed in 51 and 52-year-old men are reported. One was a tumor found in the supraglottic area of the larynx and the other was in the subglottic space. Each was a spherical tumor with a smooth surface. The chief complaints of these patients were sudden dyspnea, hoarseness, and laryngeal pain. The tumors were removed through direct laryngoscopy under general anesthesia; but in both cases, considerable bleeding occurred during and after surgery. Histological examination showed that the tumor was covered by squamous epithelium and a fibrous capsule. The parenchyma of the tumor was composed of proliferated fibers of smooth muscle, and dilated blood vessels in abundance. The tumor is of benign nature and recurrence is rare. For therapy, therefore, complete extirpation of the tumor is adequate, but the likelihood of profuse bleeding must be considered.
Angiomyoma of the upper extremities is not commonly encountered by the orthopedic surgeon. A case of a vascular leiomyoma developing in a 79-year-old woman is discussed along with a review of the literature.
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