Angioleiomyoma (ALM) is a rare benign, vascular smooth muscle tumor originating from the tunica media of the vessel wall. It typically arises in the cutaneous, subcutaneous tissue of the lower extremities in middle-aged women. The author has previously described the solid subtype of ALM as a painful and vascularized subcutaneous tumor and indicated that all painful cutaneous and subcutaneous tumors used as the acronym “ENGLAND” or “LEND an EGG” show vascularized appearances on high-resolution color
Doppler ultrasonography (US). Whereas ALMs of the fingers, toes, hands, and fee as acral type, namely acral calcified ALMs are rarely found. Kacerovska et al. mentioned that the
lesion was pathologically composed of mature smooth muscle cells and vascular pattern
accompanied with the prominent calcifications. In this article, the current knowledges of the acral calcified ALM have been reviewed in detail. Based on the evidence, acral calcified ALM pathologically shows the changes including calcification, sometimes extensive calcification hyalinization, and bleeding. Similar to the ordinary ALM, it is putative that acral calcified ALM also tends to represent painful and pathologically vascularized tumor.
In addition to the characteristic manifestation of painful and vascularized tumor on color
Doppler US, an acral calcified ALM should be considered as the differential diagnosis if the mass shows the calcification on high-resolution US in acral regions.