Case Number : Case 2422 - 11 October 2019 Posted By: Dr. Richard Carr

Angiolipoma.

Agree: Angiolipoma.

In my experience, in angiolipoma, the vessels are usually dilated and have thin walls like sinuses. Some authors even require intravascular fibrin thrombi as a component of angiolipoma. The vessels in this lesion are thick-walled of various calibers and I do not appreciate fibrin thrombi in any of the vessels. 

It is a lesion with lipomatous and vascular tissue. The question is whether the lipomatous tissue is part of the lesion or is only a bystander. I suspect this is more likely a vascular lesion involving adipose tissue. Because of the presence of vascular structures of various calibers and types, it would consider the possibility of a vascular malformation or soft tissue angiomatosis. Clinical information such as size of the lion and age of the patient might be helpful. Also, what was the original diagnosis?

Dear Anh. M39.

Chris Fletcher kindly took a look at the images and also favoured a vascular malformation and commented on the possibility of further local recurrence. Your points are all well made. I was struggling to label it and was happy to accept the lesion for what you have indicated (I too dismissed a conventional angiolipoma). I remember seeing intramuscular haemangiomas (or malformations) many moons ago with lots of adipose tissue.