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Case Reports
. 2017 Jan-Mar;16(1):68-72.
doi: 10.1590/1677-5449.000417.

Angioleiomioma oral: relato de um caso e revisão dos achados atuais

[Article in Portuguese]
Luiz Arthur Barbosa da Silva  1 , Ana Miryam Costa de Medeiros  1 , Patrícia Teixeira de Oliveira  1 , Éricka Janine Dantas da Silveira  1 , Márcia Cristina da Costa Miguel  1
Affiliations
Case Reports

Angioleiomioma oral: relato de um caso e revisão dos achados atuais

[Article in Portuguese]
Luiz Arthur Barbosa da Silva et al. J Vasc Bras. 2017 Jan-Mar.

Abstract
in English, Portuguese

Abstract: Angioleiomyoma is a benign neoplasm that was considered a tumor of smooth-muscle origin until the most recent (2013) WHO classification of soft tissue tumors, in which it was reclassified as a tumor of perivascular origin. Angioleiomyomas rarely occur in the oral cavity. These lesions are treated surgically with good prognosis. This article presents a review of reports of oral angioleiomyoma in the literature from the last 5 years and describes the case of a 44-year-old man who presented with an asymptomatic nodule in the upper lip that had developed over a 6-month period. Diagnostic hypotheses of pleomorphic adenoma or canalicular adenoma were raised. Biopsy of the lesion, histopathological and immunohistochemical analysis (S100, CD34, H-caldesmon, and desmin) confirmed a diagnosis of angioleiomyoma. It is noteworthy that immunohistochemistry is an important auxiliary method for differential diagnosis of angioleiomyoma from other tumors, particularly myopericytoma.

O angioleiomioma é uma neoplasia benigna que, a partir da nova classificação da OMS (2013) para os tumores de tecidos moles, deixou de ser considerado um tumor de origem muscular lisa, passando a ser considerado um tumor de origem perivascular. Raramente os angioleiomiomas ocorrem na cavidade oral. A lesão é tratada cirurgicamente, com prognóstico considerado favorável. Este trabalho revisa os casos de angioleiomioma oral relatados na literatura nos últimos 5 anos e descreve esse tumor em um homem de 44 anos que apresentou um nódulo assintomático localizado em lábio superior, com evolução de 6 meses. As hipóteses diagnósticas foram de adenoma pleomórfico e adenoma canalicular. A lesão foi submetida à biópsia e análise histopatológica e imuno-histoquímica (S100, CD34, α-SMA, H-caldesmon e desmina) confirmaram o diagnóstico de angioleiomioma. Destacamos a imuno-histoquímica como um importante método auxiliar no diagnóstico diferencial do angioleiomioma com outras lesões e, principalmente, com o miopericitoma.

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Conflict of interest statement

Conflito de interesse: Os autores declararam não haver conflitos de interesse que precisam ser informados.

Figures

Figura 1
Figura 1. Aspecto clínico: lesão nodular em lábio superior.
Figura 2
Figura 2. Aspectos morfológicos e imuno-histoquímicos do angioleiomioma. (A) proliferação de células com morfologias variadas (ovoides, fusiformes e onduladas) dispostas em feixes desorganizados e circundando múltiplos vasos sanguíneos (Hematoxilina & eosina, 100 µm); (B) Ausência de imunomarcação das células tumorais para proteína S100; (C) Positividade para CD34 restrita à parede vascular; (D-F) Imunomarcações fortes e difusas, respectivamente, para as proteínas α-SMA, H-caldesmon e desmina (100 µm).
Figure 1
Figure 1. Clinical appearance: nodular lesion on upper lip.
Figure 2
Figure 2. Morphological and immunohistochemical features of angioleiomyoma. (A) proliferation of cells with varied morphology (ovoid, fusiform, and ondulated) arranged in disorganized bundles and surrounding multiple blood vessels (Hematoxylin & eosin, 100 µm); (B) Absence of immunostaining of tumor cells for S100 protein; (C) Positive staining for CD34 restricted to vascular walls; (D-F) Strong and diffuse immunostaining for proteins α-SMA, H-caldesmon, and desmin, respectively (100 µm).
See this image and copyright information in PMC

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