Clin Exp Otorhinolaryngol.  2013 Sep;6(3):171-175.

Vascular Leiomyoma in the Head and Neck Region: 11 Years Experience in One Institution

• Yoon TM
• Yang HC
• Choi YD
• Lee DH
• Lee JK
• Lim SC

Abstract

OBJECTIVES
Vascular leiomyoma is an uncommon benign tumor of smooth muscle origin that arises from the muscularis layer of blood vessel walls. We report our experiences with the clinical manifestations, pathologic characteristics, and management of vascular leiomyoma in the head and neck.
METHODS
The clinical records of 12 patients with vascular leiomyoma of the head and neck in the 11-year period were reviewed retrospectively.
RESULTS
The 12 patients included nine men and three women. The locations of the tumors were variable, including nasal cavity, auricle, hard palate, upper lip, upper eyelid, and supraclavicular space. All but three patients reported an asymptomatic spherical mass; the other three patients complained of intermittent epistaxis or unilateral nasal obstruction resulting from the tumor originating in the nasal cavity. All tumors were painless. Computed tomography consistently revealed a well-defined, intensely enhanced small mass on the mucosa. No case was dignosed corretly as vascular leiomyoma before surgical excision. All patients underwent localized surgical excision of the tumor without recurrence. Five of 12 tumors (42%) were of solid type, four (33%) were of venous type, and three (25%) were of cavernous in histological classification. The histologic type was not related to gender, site of occurrence, and presence of pain.
CONCLUSION
Vascular leiomyoma presents as a small, painless mass in various locations of the head and neck region. Localized surgical excision is the only way to make the diagnosis and yields excellent results.

Keyword

Vascular leiomyoma; Diagnosis; Classification

MeSH Terms

Angiomyoma
Blood Vessels
Caves
Epistaxis
Eyelids
Female
Glycosaminoglycans
Head
Humans
Lip
Male
Mucous Membrane
Muscle, Smooth
Nasal Cavity
Nasal Obstruction
Neck
Palate, Hard
Recurrence
Glycosaminoglycans

Figure

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  Fig. 1 Contrast enhanced neck axial computed tomography (CT) finding. (A) CT scan showed well-circumscribed, strong enhanced mass (white arrow head) on the mucosa of anterior nasal septum. (B) CT scan showed round enhanced mass (white arrow head) on left anterior portion of hard palate.

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  Fig. 2 Photomicroscopic finding showing thick-walled blood vessels (black arrow head) and smooth muscle bundles (white arrow head) (H&E, ×40).

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  Fig. 3 Immunohistologic finding for actin showing strong positive reaction to actin filament of smooth muscle fibers (black arrow head) (×100).

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