Angiolipoma

Angiolipomas (also sometimes known as haemangiolipomas, vascular lipomas, and fibromyolipomas) are rare soft tissue tumours composed of mature adipocytes and vessels. They can occur essentially anywhere, and can be subclassified into infiltrating and non-infiltrating varietiesvariants ¹. 

The most common locations are the extremities and the soft tissues of the neck and trunk ².

Please refer to the epidural (spinal) angiolipoma article for a specific discussion. The remainder of this article describedescribes the general features of peripheral angiolipomas.

Epidemiology

Typically occur in young adults, appearing on the forearm (most common location), trunk and upper arm. They are more common in males. The most common presentation is of multiple, small (<2 cm), subcutaneous, tender nodules ^2,3.

Infiltrating angiolipomas are much rarer than the non-infiltrating variant. They occur in children and adults and have no sex predilection. They most commonly appear in the muscles of the lower extremity, neck, and shoulder, and are usually painless ⁵.

Radiographic features

As expected, these masses contain a mixture of softadipose tissue and fatty components, with prominent vascular supply.

MRI

Angiolipomas demonstrate heterogeneous signal due to mixtureintensity characteristics of fattymature adipose tissue. Vascular elements are T1-hypointense and non-fatty components. Non-fatty componentsT2 hyperintense and enhance vividly following administration of contrast ²³.

Angiography

Catheter angiography demonstrates prominent coarse neovascularity. During the capillary phase, contrast staining is typically seen ¹.

Treatment and prognosis

Treatment is predominantly surgical, although infiltrating tumours are difficult to completely excise ¹ and, as mentioned above, tend to recur locally.²