Angiolipoma

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. These lesions are well-defined, usually measuring less than 4 cm.

Causes

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

Diagnosis

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

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. The lesion may be adipocytic, and the degree of capillary development can range from negligible to prominent (cellular angiolipoma).

Treatment

Total excision or liposuction is the appropriate course of action for the management of angiolipomas. After excision, the non-infiltrating subtype typically does not recur. 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.

Epidemiology

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

References

References

1. James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. {{ISBN. 0-7216-2921-0.
2. Rapini, Ronald P.. (2007). "Dermatology: 2-Volume Set". Mosby.
3. (1981). "Angiolipomas: An ultrastructural and clinicopathological study". Elsevier BV.
4. HOWARD, W. R.. (1960-12-01). "Angiolipoma". American Medical Association (AMA).
5. (2020-06-10). "Angiolipoma in the Head and Neck: Imaging, Diagnosis and Management". MDPI AG.
6. (1980). "Familial angiolipomatosis". Wiley.
7. (2015-09-29). "Thrombosis of multiple angiolipomas due to acenocumarol treatment". Wiley.
8. (2017-02-27). "Frequent low-level mutations of protein kinase D2 in angiolipoma". Wiley.
9. (2022). "Multiple angiolipoma of the hand, back, and abdomen; a case report". Elsevier BV.
10. (2011). "Angiolipoma of the cheek: A case report with a literature review". Elsevier BV.
11. (1999-02-24). "Multiple hepatic angiolipomas: a case report and review of literature". Springer Science and Business Media LLC.
12. (1997). "Cytogenetic Analysis of Subcutaneous Angiolipoma: Further Evidence Supporting Its Difference from Ordinary Pure Lipomas". Ovid Technologies (Wolters Kluwer Health).
13. (2019). "Practical Soft Tissue Pathology: a Diagnostic Approach". Elsevier.
14. (1990). "Cellular Angiolipoma". Ovid Technologies (Wolters Kluwer Health).
15. (2002). "Multiple subcutaneous angiolipomas associated with new-onset diabetes mellitus". Wiley.
16. (2020-12-16). "Dorsolumbar angiolipoma: A rare case report and review of literature". Romanian Neurosurgery.
17. (2005). "Angiolipoma of the Neck: A Case Report". Ear, Nose & Throat Journal.