Angioleiomyoma mimicking a swollen bursa on first metatarsophalangeal joint accompanying with hallux valgus deformity.

Kotaro Matsuda, Makoto Hirao, Takaaki Noguchi, Gensuke Okamura, Yoshihiko Hoshida, Yuki Etani, Kosuke Ebina, Seiji Okada, Koji Hiraoka, Jun Hashimoto
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Abstract

We present a case of a patient who underwent a modified scarf osteotomy and tumour excision based on a preoperative diagnosis of hallux valgus deformity and accompanying bursitis. Subsequent histopathological examination revealed that the tumour was an angioleiomyoma. While tumours around the first metatarsophalangeal (MTP) joint are typically associated with gouty nodules, infections, or swollen bursa (bursitis) in patients with hallux valgus deformity, the occurrence of soft tissue tumours in this area is rare. Moreover, angioleiomyoma is an even rarer form of soft tissue tumour and is seldom suspected prior to resection. To our knowledge, there have been no reports of angioleiomyoma arising in the first MTP joint. However, it is important to consider the possibility of an atypical tumour in cases where soft tissue masses are present, even in patients with hallux valgus deformity, and to perform at least imaging tests such as ultrasound and magnetic resonance imaging before surgery. This prospect should always be kept in mind.

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血管网状肌瘤模仿第一跖趾关节滑囊肿胀,伴有拇指外翻畸形。
我们介绍了一例患者的病例,患者术前诊断为拇指外翻畸形并伴有滑囊炎,因此接受了改良疤痕截骨术和肿瘤切除术。随后的组织病理学检查显示肿瘤为血管瘤。虽然第一跖趾关节(MTP)周围的肿瘤通常与拇指外翻畸形患者的痛风结节、感染或滑囊肿胀(滑囊炎)有关,但这一区域发生软组织肿瘤的情况并不多见。此外,血管网状肌瘤是一种更为罕见的软组织肿瘤,在切除前很少被怀疑。据我们所知,目前还没有关于血管网状肌瘤发生在第一 MTP 关节处的报道。不过,在出现软组织肿块的病例中,即使是有足外翻畸形的患者,也必须考虑到非典型肿瘤的可能性,并在手术前至少进行超声波和磁共振成像等影像学检查。应始终牢记这一前景。
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