Presentation
Progressive painless swelling of the thenar eminence of the left hand over 20 years.
Patient Data
Well-defined oval-shaped vascularized mass, relatively isoechogenic to the muscle containing hypo-and hyperechogenic punctuate areas.
Oval-shaped well-circumscribed soft tissue mass at the thenar eminence of extramuscular location between the palmar aponeurosis ventrally, thenar muscles dorsally and 1st lumbrical muscle medially. It elicits a slight high signal to the muscle on T1, inhomogeneous high signal on T2 and T2 fat sat with no calcification or hemorrhagic component on GE sequence. Progressive heterogeneous enhancement on postcontrast sequences. The DWI (motion artifact) shows a high signal with an ADC almost identical to that of the muscles.
Case Discussion
Ultrasound and MRI features of a well-circumscribed vascularized soft tissue mass at the thenar eminence with no invasion of the adjacent soft tissues.
The patient went on to have complete resection of the tumor. The histopathological report was angiomyolipoma.
Angiomyolipomas are predominantly observed in the kidney (renal angiomyolipoma) but occasionally occur in other organs such as the liver (hepatic angiomyolipoma), isolated or patients with tuberous sclerosis.
Very rarely they can occur in unusual locations such as:
- cutaneous angiomyolipoma
- retroperitoneal angiomyolipoma
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