Angiolipoma is a subcutaneous nodule with vascular structure, having all other features of a typical

lipoma A lipoma is a benign tumor made of adipose tissue, fat tissue. They are generally soft to the touch, movable, and painless. They usually occur just under the skin, but occasionally may be deeper. Most are less than in size. Common locations inc ...

. They are commonly painful.James, William; Berger, Timothy; Elston, Dirk (2005). ''Andrews' Diseases of the Skin: Clinical Dermatology''. (10th ed.). Saunders. . Angiolipomas manifest as multiple painful subcutaneous

nodules Nodule may refer to: *Nodule (geology), a small rock or mineral cluster *Manganese nodule, a metallic concretion found on the seafloor *Nodule (medicine), a small aggregation of cells *Root nodule Root nodules are found on the roots of plants, p ...

commonly on the upper limbs. The can occur sporadically, with a family history or after trauma. Angiolipomas can be seen on

CT scan A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

s and

MRI Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and rad ...

but are diagnosed based on

histopathology Histopathology (compound of three Greek words: 'tissue', 'suffering', and '' -logia'' 'study of') is the microscopic examination of tissue in order to study the manifestations of disease. Specifically, in clinical medicine, histopatholog ...

. Total excision or

liposuction Liposuction, or simply lipo, is a type of fat-removal procedure used in plastic surgery. Evidence does not support an effect on weight beyond a couple of months and does not appear to affect obesity-related problems. In the United States, lip ...

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

(solitary in only one-third of patients), most commonly originating in the upper limbs (of which the

forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is used to describe the entire appendage of the upper limb, but which in anatomy, techn ...

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 A computed tomography scan (CT scan), formerly called computed axial tomography scan (CAT scan), is a medical imaging technique used to obtain detailed internal images of the body. The personnel that perform CT scans are called radiographers or ...

(CT) with a hyperechoic mass and

magnetic resonance imaging Magnetic resonance imaging (MRI) is a medical imaging technique used in radiology to generate pictures of the anatomy and the physiological processes inside the body. MRI scanners use strong magnetic fields, magnetic field gradients, and ...

(MRI). Nevertheless, these techniques are not very good at giving a conclusive diagnosis for these

malignancies Malignancy () is the tendency of a medical condition to become progressively worse; the term is most familiar as a characterization of cancer. A ''malignant'' tumor contrasts with a non-cancerous ''benign'' tumor in that a malignancy is not ...

. 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 A capillary is a small blood vessel, from 5 to 10 micrometres in diameter, and is part of the microcirculation system. Capillaries are microvessels and the smallest blood vessels in the body. They are composed of only the tunica intima (the inn ...

-sized proliferation that makes up the majority of the vascular network is more noticeable towards the periphery. The presence of

fibrin Fibrin (also called Factor Ia) is a fibrous protein, fibrous, non-globular protein involved in the Coagulation, clotting of blood. It is formed by the action of the protease thrombin on fibrinogen, which causes it to polymerization, polymerize. ...

microthrombi, a nearly unique morphologic characteristic of angiolipoma, is characteristic of the

blood vessel Blood vessels are the tubular structures of a circulatory system that transport blood throughout many Animal, animals’ bodies. Blood vessels transport blood cells, nutrients, and oxygen to most of the Tissue (biology), tissues of a Body (bi ...

s. The lesion may be adipocytic, and the degree of

development can range from negligible to prominent (cellular angiolipoma).

Treatment

Total excision or

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 third and second decades of life. They primarily affect men.

References

External links

Cleveland Clinic

DermNet
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