Case Reports in Dentistry

Case Report

Clinical, Imaging and Histopathology of Angioleiomyoma of the Buccal Cheek

Table 1

Review of various studies on angioleiomyoma of head and neck. cm: centimeter; CT: computed tomography; D: day; F: female; H&E: hematoxylin and eosin; IHC: immunohistochemistry; M: male; Mo: month; mm: millimeter; MRI: magnetic resonance imaging; SMA: smooth muscle actin; Y: year; YO: years old.
NoAuthor & yearAge & sexLocationSizeSign & symptomsRadiologic assessmentsTreatment planAnesthesiaHistologic assessmentsFollow-up
1Mehta et al., 2020 [15]57 YO, MLower lipExophytic nodular swelling—Surgical excisionLocalH&E:
Large vascular channels of varying caliber, surrounded by thick walls of irregularly arranged spindle-shaped cells. Whorled bundles of muscle fibers were seen fused with the vessel walls
IHC:
SMA+		3 Mo, no recurrence
2Giudice et al., 2019 [32]17 YO, FCheekSwelling—Surgical excisionLocalH&E:
Uniform spindle smooth muscle cells with pale eosinophilic cytoplasm, low amount of fibrous connective tissue, and distributed around numerous small tortuous “slit-like” vessels
IHC:
SMA+
CD34+
Desmin+
Vimentin+		1 week, 4 weeks, 6 months
No recurrence
3Pandya et al., 2019 [23]46 YO, FPalateExophytic growth, painOcclusal plain filmSurgical excisionLocalH&E:
Numerous thick-walled blood vessels in the connective tissue formed of hyperplastic smooth muscle fibers
IHC:
SMA+		6 Mo, no recurrence
4Perić et al., 2019 [4]36 YO, MLipPainless swelling—Surgical excisionLocalH&E:
Numerous thick-walled vessel
IHC:
CD34+
SMA+		7 D, normal healing
5Ribeiro et al., 2019 [18]60 YO, MAnterior maxillary labial fold—Swelling—Surgical excision—H&E:
Multiple vessels, thickened muscular layer
IHC:
CD34+
SMA+		2 Y, no recurrence
6Ribeiro et al., 2019 [18]33 YO, MBuccal mucosaSubmucosal noduleColor Doppler ultrasonography: well-limited hyperechoic area between cutaneous and muscular layers, no change in blood flowSurgical excisionH&E:
Multiple vascular spaces of various sizes and calibers, sometimes congested and interconnected
IHC:
CD34-
SMA+
7S.Y. Rawal and Y.B. Rawal, 2018 [22]70 YO, MHard palatePainless mass—Surgical excision—H&E:
Brightly eosinophilic, spindle-shaped cells
IHC:
SMA+		—
8Hassona et al., 2017 [14]52 YO, FUpper lip—Painless mass—Surgical excisionLocalH&E:
Vascular channels surrounded by fascicles of concentrically arranged spindle cells with eosinophilic cytoplasm
IHC:
SMA+		12 Mo, no recurrence
9Osano et al., 2015 [5]45 YO, MCheekPainless massMRI:
T1+contrast: homogeneously enhanced mass and a vessel leading to the tumor
T2:
Uniform signal and hyperintense signal		Surgical excisionGeneralH&E:
Proliferation of vessels with a smooth muscle wall and vessels surrounded by smooth muscle cells
IHC:
SMA+
Desmin+
Vimentin+		18 Mo, no recurrence
10Ishikawa et al., 2014 [6]51 YO, MTongue11 mmNodular mass—Surgical excision—H&E:
Brightly eosinophilic, spindle-shaped cells
IHC:
SMA+
HHF-35 actin+
Vimentin+
Desmin+
S100-
CD34-		8 Mo, no recurrence
11Tsuji et al., 2014 [7]79 YO, MHard palatePainless swellingPanoramic:
No source of odontogenic infection
CT:
Well-circumscribed mass, no evidence of surrounding bone resorption		Surgical removal and curettageLocalH&E:
Vascular spaces and redundant smooth muscle
IHC:
Desmin+
SMA+		6 Mo, no recurrence
12Eley et al., 2012 [21]39 YO, MHard palate2 cmPainless swellingMRI:
T1:
Slightly higher than the surrounding soft tissue
T2:
Marked hyper intensity		Surgical excisionGeneralH&E:
Vascular channels surrounded by fascicles of spindle cells
IHC:
Desmin+
SMA+		3 Mo, no recurrence
13Minni et al., 2012 [11]54 YO, FSubmandibular spacePainless swellingMRI:
Displacement of submandibular gland, tongue, and oropharynx airway
Compressing the right tonsil
Ultrasound-guided FNA:
Blood-stained aspirate		Complete surgical removalGeneralH&E:
Smooth muscle tissue punctuated with thick-walled vessels, capillary, and venous-type vessels
IHC:
SMA+		6 Mo, no recurrence
14Menditti et al., 2012 [10]14 YO, MGingiva1-2 cmPainless swelling—Radical excision with 2 mm free marginsLocalH&E:
Vascular spaces and redundant smooth muscle
IHC:
SMA+		1 Y, no recurrence
15Gueiros et al., 2011 [16]-54 YO, M
-66 YO, M
-53 YO, M		Lower lip
Upper lip
Upper lip
Painless nodule—Surgical excisionLocalH&E:
Spindle-shaped cells and blood vessels
IHC:
MSA+		-2 Y
-1 Y
-6 Mo, no recurrence
16Vidaković et al., 2011 [8]58 YO, MCheekPainless swelling—Surgical excisionLocalH&E:
Thick-walled vessels with partially patent and smooth muscle fibres		7 D, normal healing of wound
17Kim et al., 2010 [3]2 YO, MTongueSoft tissue massMRI:
Elevated mass on the base of the tongue
T1:
Isointense signal to muscle
T2:
Slightly hyperintense signal with hyperintense rim		Surgical removalGeneralH&E:
Prominent and thickened vessel walls consisting of benign and mature smooth muscle cells
IHC:
Desmin+
SMA+		26 Mo, no recurrence
18Nonaka et al., 2010 [25]38 YO, MTongue2 cmPainless exophytic mass—Surgical excision—H&E:
Proliferation of spindle-shaped nucleus cells, numerous blood vessels
IHC:
SMA+		1 Y, no recurrence
19Keerthi et al., 2009 [17]32 YO, MCheekPainless swellingCT:
Large nonhomogenously enhancing mixed density lesion in the infratemporal fossa and the buccal space, moderately enhancing soft tissue component superolaterally, with no calcification or necrosis		Surgical removalGeneralH&E:
Multiple blood vessels with proliferation of smooth muscle		6 Y, no recurrence
20Keerthi et al., 2009 [17]32 YO, MCheekPainless swellingPlain film radiograph:
No bony changes
Ultrasound:
Hypoechoic lesion more in favor of soft tissue swelling		Surgical removalGeneralH&E:
Spindle-shaped fascicles and many blood vessels
IHC:
Masson trichrome stain (+)		1 Y, no occurrence
21McParland et al., 2009 [19]42 YO, MBuccal mucosalPainless swelling—Surgical excisionLocalH&E:
Smooth muscle bands are surrounded by slit-like vascular spaces		6 Mo, no recurrence
22Cepeda et al., 2008 [2]39 YO, F
27 YO, F
43 YO, F
36 YO, M
48 YO, M		Retromolar area
Mandibular region
Lower lip
Upper lip
Upper lip



Painless massRoutine radiographic inspection:
A unilocular radiolucency located in a mandibular region (in case 2)		Surgical excision—H&E:
Several blood vessels lined by a thin layer of endothelial cells were observed intercalated in the fascicules
IHC:
SMA+
Vimentin+
Desmin+
CD34-
23Manor et al., 2007 [20]39 YO, MBuccal vestibule8Asymptomatic massCT:
Hypervascular soft tissue mass, with no invasion of the periosteum or bone		Surgical excision—H&E:
Bands of smooth muscle cells surrounding multiple vascular spaces of varying size
IHC:
SMA+		12 Mo, no recurrence
24Ide et al., 2003 [26]40 YO, FSubmandibular glandPainful swelling—Surgical excisionH&E:
Tortuous thick-walled vessels in varying sizes, proliferation of smooth muscle
IHC:
SMA+
CD31–
CD34–
S-100-
25Toida et al., 2000 [12]10 YO, MLower lipPainful mass—Surgical excisionLocalH&E:
Spindle cells surrounded by numerous slit-like vessels
IHC:
SMA+
S-100-		3 Y, no recurrence
26Simon et al., 2000 [9]59 YO, FSubmandibular triangleNontender massColor Doppler ultrasound:
Well-circumscribed, homogeneous solid mass attached to the posterior surface of the submandibular gland, vascularity within the mass		Surgical excisionGeneralH&E:
Smooth muscle punctuated with thick-walled venous vascular channels		—