Angiolipoma Explained

Angiolipoma

Angiolipoma is a subcutaneous nodule with vascular structure, having all other features of a typical lipoma. They are commonly painful.[1] [2] Angiolipomas manifest as multiple painful subcutaneous nodules commonly on the upper limbs. The can occur sporadically, with a family history or after trauma. Angiolipomas can be seen on CT scans and MRI but are diagnosed based of histopathology. Total excision or liposuction is used to treat angiolipomas. They are more common in med and usually appear in third and second decades of life.

Signs and symptoms

Angiolipoma typically manifests as many, painful subcutaneous nodules (solitary in only one-third of patients), most commonly originating in the upper limbs (of which the forearm accounts for around two thirds), trunk, and lower limbs.[3] [4] These lesions are well-defined, usually measuring less than 4 cm.[5]

Causes

The majority of the time, angiolipomas happen randomly, however in a small percentage of cases, a familial history is apparent.[6] Usually, a history of trauma is linked to it.[7] Angiolipomas frequently have PRKD2 mutations, according to a recent study.[8]

Diagnosis

Preoperative diagnostics for angiolipoma usually involve computed tomography (CT) with a hyperechoic mass and magnetic resonance imaging (MRI).[9] Nevertheless, these techniques are not very good at giving a conclusive diagnosis for these malignancies.[10] [11] For this reason, a histological study is frequently necessary to provide a definitive diagnosis.[12]

From a histological perspective, angiolipomas exhibit a variable mature adipocytic growth linked to a vascular component. The capillary-sized proliferation that makes up the majority of the vascular network is more noticeable towards the periphery. The presence of fibrin microthrombi, a nearly unique morphologic characteristic of angiolipoma, is characteristic of the blood vessels.[13] The lesion may be adipocytic, and the degree of capillary development can range from negligible to prominent (cellular angiolipoma).[14]

Treatment

Total excision or liposuction is the appropriate course of action for the management of angiolipomas.[15] After excision, the non-infiltrating subtype typically does not recur.[16] Wide excision with distinct margins is necessary to reduce the likelihood of recurrence because the infiltrating subtype is linked to a 35% to 50% recurrence rate.[17]

Epidemiology

Angiolipoma represent 5% to 17% of all lipomas. Peak incidence occurs in the third and second decades of life. They primarily affect men.[13]

See also

Further reading

External links

Notes and References

  1. James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. .
  2. Book: Rapini, Ronald P. . Bolognia, Jean L. . Jorizzo, Joseph L. . Dermatology: 2-Volume Set . Mosby . St. Louis . 2007 . 1838 . 978-1-4160-2999-1 .
  3. Dixon . Anita Y. . McGregon . Douglas H. . Lee . Saing H. . Angiolipomas: An ultrastructural and clinicopathological study . Human Pathology . Elsevier BV . 12 . 8 . 1981 . 0046-8177 . 10.1016/s0046-8177(81)80176-1 . 739–747.
  4. HOWARD . W. R. . Angiolipoma . Archives of Dermatology . American Medical Association (AMA) . 82 . 6 . 1960-12-01 . 0003-987X . 10.1001/archderm.1960.01580060078011 . 924. 13716236 .
  5. Reiser . Vadim . Haj Yahya . Bahaa . Chaushu . Gavriel . Kaplan . Ilana . Hamzani . Yafit . Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management . Medicina . MDPI AG . 56 . 6 . 2020-06-10 . 1648-9144 . 10.3390/medicina56060283 . free . 283. 32532063 . 7353847 .
  6. Hapnes . Sveln A. . Boman . Helge . Seeie . Sverre O. . Familial angiolipomatosis . Clinical Genetics . Wiley . 17 . 3 . 1980 . 0009-9163 . 10.1111/j.1399-0004.1980.tb00133.x . 202–208. 7363507 .
  7. Álvarez-López . María Ángeles . Salvatierra . Juan . Sanz . Andres . Thrombosis of multiple angiolipomas due to acenocumarol treatment . Journal of Cutaneous Pathology . Wiley . 42 . 11 . 2015-09-29 . 0303-6987 . 10.1111/cup.12600 . 919–920.
  8. Hofvander . Jakob . Arbajian . Elsa . Stenkula . Karin G . Lindkvist-Petersson . Karin . Larsson . Malin . Nilsson . Jenny . Magnusson . Linda . von Steyern . Fredrik Vult . Rissler . Pehr . Hornick . Jason L . Mertens . Fredrik . Frequent low-level mutations of protein kinase D2 in angiolipoma . The Journal of Pathology . Wiley . 241 . 5 . 2017-02-27 . 0022-3417 . 10.1002/path.4865 . 578–582. 28139834 .
  9. Hassan . Hunar A. . Hassan . Hemn A. . Ali . Rebwar A. . Omar . Diyar A. . Salih . Abdulwahid M. . Kakamad . Fahmi H. . Multiple angiolipoma of the hand, back, and abdomen; a case report . International Journal of Surgery Case Reports . Elsevier BV . 93 . 2022 . 2210-2612 . 10.1016/j.ijscr.2022.106901 . 106901. 8927707 .
  10. Yanase . Shigeaki . Nomura . Jouji . Matsumura . Yoshihiko . Kato . Hideharu . Takeoka . Takashi . Imura . Hiroko . Matsuura . Rina . Nakanishi . Ko . Tagawa . Toshiro . Angiolipoma of the cheek: A case report with a literature review . Asian Journal of Oral and Maxillofacial Surgery . Elsevier BV . 23 . 1 . 2011 . 0915-6992 . 10.1016/j.ajoms.2010.09.002 . 35–37.
  11. Strotzer . M. . Paetzel . C. . Feuerbach . S. . Multiple hepatic angiolipomas: a case report and review of literature . European Radiology . Springer Science and Business Media LLC . 9 . 2 . 1999-02-24 . 0938-7994 . 10.1007/s003300050665 . 259–261. 10101648 .
  12. Sciot . Raf . Akerman . Mans . Cin . Paola Dal . De Wever . Ivo . Fletcher . Christopher D. M. . Mandahl . Nils . Mertens . Fredrik . Mitelman . Felix . Rosai . Juan . Rydholm . Anders . Tallini . Giovanni . Van den Berghe . Herman . Vanni . Roberta . Willen . Helena . Cytogenetic Analysis of Subcutaneous Angiolipoma: Further Evidence Supporting Its Difference from Ordinary Pure Lipomas . The American Journal of Surgical Pathology . Ovid Technologies (Wolters Kluwer Health) . 21 . 4 . 1997 . 0147-5185 . 10.1097/00000478-199704000-00010 . 441–444. 9130991 .
  13. Book: Sbaraglia . Marta . Dei Tos . Angelo Paolo . Practical Soft Tissue Pathology: a Diagnostic Approach . Adipocytic Tumors . Elsevier . 2019 . 978-0-323-49714-5 . 10.1016/b978-0-323-49714-5.00012-0 . 311–340.
  14. Hunt . Steven J. . Cruz . Daniel J. Santa . Barr . Ronald J. . Cellular Angiolipoma . The American Journal of Surgical Pathology . Ovid Technologies (Wolters Kluwer Health) . 14 . 1 . 1990 . 0147-5185 . 10.1097/00000478-199001000-00008 . 75–81. 2294783 .
  15. Levitt . Jacob . Lutfi Ali . Suad A. . Sapadin . Allen . Multiple subcutaneous angiolipomas associated with new-onset diabetes mellitus . International Journal of Dermatology . Wiley . 41 . 11 . 2002 . 0011-9059 . 10.1046/j.1365-4362.2002.01445.x . 783–785. 12453005 .
  16. Gupta . Surendra Kumar . Chhabra . Anuj . Prajapati . Hanuman Kumar . Ahmad . Faran . Dorsolumbar angiolipoma: A rare case report and review of literature . Romanian Neurosurgery . 2020-12-16 . 2344-4959 . 10.33962/roneuro-2020-092 . 540–543. free .
  17. Saydam . Levent . Bozkurt . Mete Kaan . Ugur . Mehmet Birol . Ozcelik . Tuncay . Kutluay . Lale . Angiolipoma of the Neck: A Case Report . Ear, Nose & Throat Journal . 84 . 6 . 2005 . 0145-5613 . 10.1177/014556130508400620 . 375–377.

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