Angiolipoma

Angiolipoma
Angiolipoma
	Large mediastinal angiolipoma
Specialty	Oncology

Angiolipoma is a subcutaneous nodule with vascular structure, having all other features of a typical lipoma. They are commonly painful.^[1]^: 624^[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 men 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.^[5] Peak incidence occurs in the third and second decades of life. They primarily affect men.^[13]

References

^ James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1838. ISBN 978-1-4160-2999-1.
^ Dixon, Anita Y.; McGregon, Douglas H.; Lee, Saing H. (1981). "Angiolipomas: An ultrastructural and clinicopathological study". Human Pathology. 12 (8). Elsevier BV: 739–747. doi:10.1016/s0046-8177(81)80176-1. ISSN 0046-8177. PMID 7026412.
^ HOWARD, W. R. (1960-12-01). "Angiolipoma". Archives of Dermatology. 82 (6). American Medical Association (AMA): 924–931. doi:10.1001/archderm.1960.01580060078011. ISSN 0003-987X. PMID 13716236.
^ ^a ^b Reiser, Vadim; Haj Yahya, Bahaa; Chaushu, Gavriel; Kaplan, Ilana; Hamzani, Yafit (2020-06-10). "Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management". Medicina. 56 (6). MDPI AG: 283. doi:10.3390/medicina56060283. ISSN 1648-9144. PMC 7353847. PMID 32532063.
^ Hapnes, Sveln A.; Boman, Helge; Seeie, Sverre O. (1980). "Familial angiolipomatosis". Clinical Genetics. 17 (3). Wiley: 202–208. doi:10.1111/j.1399-0004.1980.tb00133.x. ISSN 0009-9163. PMID 7363507.
^ Álvarez-López, María Ángeles; Salvatierra, Juan; Sanz, Andres (2015-09-29). "Thrombosis of multiple angiolipomas due to acenocumarol treatment". Journal of Cutaneous Pathology. 42 (11). Wiley: 919–920. doi:10.1111/cup.12600. ISSN 0303-6987. PMID 26418501.
^ 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 (2017-02-27). "Frequent low-level mutations of protein kinase <scp>D2</scp> in angiolipoma". The Journal of Pathology. 241 (5). Wiley: 578–582. doi:10.1002/path.4865. ISSN 0022-3417. PMID 28139834.
^ Hassan, Hunar A.; Hassan, Hemn A.; Ali, Rebwar A.; Omar, Diyar A.; Salih, Abdulwahid M.; Kakamad, Fahmi H. (2022). "Multiple angiolipoma of the hand, back, and abdomen; a case report". International Journal of Surgery Case Reports. 93. Elsevier BV: 106901. doi:10.1016/j.ijscr.2022.106901. ISSN 2210-2612. PMC 8927707. PMID 35298986.
^ Yanase, Shigeaki; Nomura, Jouji; Matsumura, Yoshihiko; Kato, Hideharu; Takeoka, Takashi; Imura, Hiroko; Matsuura, Rina; Nakanishi, Ko; Tagawa, Toshiro (2011). "Angiolipoma of the cheek: A case report with a literature review". Asian Journal of Oral and Maxillofacial Surgery. 23 (1). Elsevier BV: 35–37. doi:10.1016/j.ajoms.2010.09.002. ISSN 0915-6992.
^ Strotzer, M.; Paetzel, C.; Feuerbach, S. (1999-02-24). "Multiple hepatic angiolipomas: a case report and review of literature". European Radiology. 9 (2). Springer Science and Business Media LLC: 259–261. doi:10.1007/s003300050665. ISSN 0938-7994. PMID 10101648.
^ 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 (1997). "Cytogenetic Analysis of Subcutaneous Angiolipoma: Further Evidence Supporting Its Difference from Ordinary Pure Lipomas". The American Journal of Surgical Pathology. 21 (4). Ovid Technologies (Wolters Kluwer Health): 441–444. doi:10.1097/00000478-199704000-00010. ISSN 0147-5185. PMID 9130991.
^ ^a ^b Sbaraglia, Marta; Dei Tos, Angelo Paolo (2019). "Adipocytic Tumors". Practical Soft Tissue Pathology: a Diagnostic Approach. Elsevier. pp. 311–340. doi:10.1016/b978-0-323-49714-5.00012-0. ISBN 978-0-323-49714-5.
^ Hunt, Steven J.; Cruz, Daniel J. Santa; Barr, Ronald J. (1990). "Cellular Angiolipoma". The American Journal of Surgical Pathology. 14 (1). Ovid Technologies (Wolters Kluwer Health): 75–81. doi:10.1097/00000478-199001000-00008. ISSN 0147-5185. PMID 2294783.
^ Levitt, Jacob; Lutfi Ali, Suad A.; Sapadin, Allen (2002). "Multiple subcutaneous angiolipomas associated with new-onset diabetes mellitus". International Journal of Dermatology. 41 (11). Wiley: 783–785. doi:10.1046/j.1365-4362.2002.01445.x. ISSN 0011-9059. PMID 12453005.
^ Gupta, Surendra Kumar; Chhabra, Anuj; Prajapati, Hanuman Kumar; Ahmad, Faran (2020-12-16). "Dorsolumbar angiolipoma: A rare case report and review of literature". Romanian Neurosurgery: 540–543. doi:10.33962/roneuro-2020-092. ISSN 2344-4959.
^ Saydam, Levent; Bozkurt, Mete Kaan; Ugur, Mehmet Birol; Ozcelik, Tuncay; Kutluay, Lale (2005). "Angiolipoma of the Neck: A Case Report". Ear, Nose & Throat Journal. 84 (6): 375–377. doi:10.1177/014556130508400620. ISSN 0145-5613. PMID 16075864.