# Uterine Angioleiomyoma: Clinical and Histopathologic Differentiation of an Underrecognized Mimicker of Uterine Leiomyoma

## TL;DR

This paper describes a rare case of uterine angioleiomyoma, a benign tumor that can be mistaken for a uterine leiomyoma, and highlights its unique features for accurate diagnosis.

## Contribution

The study presents a new case of uterine angioleiomyoma and emphasizes its distinct clinicopathological characteristics to improve recognition.

## Key findings

- Uterine angioleiomyoma has distinct imaging, macroscopic, and microscopic features that differentiate it from leiomyoma.
- The tumor's location in the myometrium correlates with contrast enhancement seen on preoperative imaging.
- Accurate diagnosis of uterine angioleiomyoma is crucial for understanding its clinicopathological behavior.

## Abstract

Angioleiomyoma is an uncommon benign neoplasm of mesenchymal origin that arises from perivascular smooth muscle cells. This soft tissue neoplasm usually occurs in the dermal or subcutaneous tissues of the extremities, head and neck, or trunk with fewer than 40 reported angioleiomyomas arising in the uterine corpus. Herein we report a uterine angioleiomyoma in a 44-year-old G5P4 Hispanic woman with a longstanding history of recurrent abdominal pain, pelvic organ prolapse, abnormal uterine bleeding, anemia, and hypertension. The patient underwent surgical treatment with total laparoscopic hysterectomy with bilateral salpingectomy and a uterosacral ligament suspension. Uterine angioleiomyoma was diagnosed post-operatively based on gross and microscopic features. The location of the uterine angioleiomyoma within the myometrium corresponded with contrast enhancement apparent on preoperative imaging. This and other uterine angioleiomyomas have characteristic imaging, macroscopic, and microscopic features which distinguish it from leiomyoma. Enhancing awareness of this underrecognized entity will facilitate precise diagnosis and thereby enable improved understanding of the clinicopathological characteristics of uterine angioleiomyoma.