Angioleiomyoma of the Extremities: Findings on Ultrasonography and Magnetic Resonance Imaging

Objectives The purpose of this study was to describe the features of angioleiomyomas of the extremities on ultrasonography (US) and magnetic resonance imaging (MRI). Methods We retrospectively reviewed the US and MRI findings of 29 pathologically confirmed cases of angioleiomyomas of the extremities in 29 patients. Twenty patients underwent only US; 7 patients underwent only MRI; and 2 patients underwent US and MRI. Clinical data and histopathologic specimens were reviewed. Results There were 19 women and 10 men. The mean patient age was 48.9 years (range, 23–80 years). On US, angioleiomyomas were located primarily in the subcutaneous fat layer (n = 20 [91%]), were oval (n = 17 [77%]), had well‐circumscribed margins (n = 22 [100%]), had hypoechoic protrusions on one or both ends (n = 9 [41%]), had a homogeneous echo texture (n = 17 [ 77%]), had posterior acoustic enhancement (n = 20 [91%]), and had color Doppler flow (n = 20 [91%]). On MRI, the masses showed heterogeneous enhancement (n = 7 [88%]) and enhancing structures on one or both ends (n = 4 [50%]) on contrast‐enhanced T1‐weighted images. Conclusions Angioleiomyoma of the extremities is usually a well‐circumscribed oval mass with a homogeneous echo texture and occasionally hypoechoic protrusions on US and shows heterogeneous enhancement with occasionally enhancing structures on one or both ends of the mass on MRI. Therefore, it should be included in the differential diagnosis of a soft tissue mass that has protruding structures from one or both ends.