Ann Dermatol.  2009 Feb;21(1):78-80. 10.5021/ad.2009.21.1.78.

A Case of Acquired Smooth Muscle Hamartoma on the Sole

• Lee D
• Kim SH
• Hong SK
• Sung HS
• Hwang SW

• KMID: 2172074
• DOI: http://doi.org/10.5021/ad.2009.21.1.78

Abstract

A smooth muscle hamartoma is a benign proliferation of smooth muscle bundles within the dermis. It arises from smooth muscle cells that are located in arrector pili muscles, dartos muscles, vascular smooth muscles, muscularis mammillae and the areolae. Acquired smooth muscle hamartoma (ASMH) is rare, with only 10 such cases having been reported in the English medical literature to date. Most of these cases of ASMH were shown to have originated from arrector pili and dartos muscles. Only one case was reported to have originated from vascular smooth muscle cells. A 21 year-old woman presented with a tender pigmented nodule, with numbness, on the sole of her foot, and this lesion had developed over the previous 18 months. The lesion showed no hyperpigmentation or hypertrichosis, and the biopsies demonstrated increased smooth muscle bundles in the dermis, and especially around the blood vessels. Moreover, the specimens stained positive with Masson trichrome stain and alpha-smooth-muscle actin antibodies, thus supporting our diagnosis of ASMH of the foot sole. Herein, we report on a rare case of ASMH on the foot sole, and this lesion originated from vascular smooth muscle cells. This type of case has not been previously described in the English medical literature.

Keyword

Acquired smooth muscle hamartoma; Sole; Vascular smooth muscle cell

MeSH Terms

Actins
Antibodies
Azo Compounds
Biopsy
Blood Vessels
Dermis
Eosine Yellowish-(YS)
Female
Foot
Hamartoma
Humans
Hyperpigmentation
Hypertrichosis
Hypesthesia
Methyl Green
Muscle, Smooth
Muscle, Smooth, Vascular
Muscles
Myocytes, Smooth Muscle
Actins
Antibodies
Azo Compounds
Eosine Yellowish-(YS)
Methyl Green

Figure

• 

  Fig. 1 A skin colored, 0.5×0.5 cm sized tender nodule on the right sole.

• 

  Fig. 2 An increased number of haphazardly oriented bundles of smooth muscle cells were observed in the dermis (A: H&E stain, ×40, B: H&E stain, ×100).

• 

  Fig. 3 The haphazardly arranged smooth muscle bundles were mainly located around blood vessels (A: Masson's trichrome stain, ×40, B: α-smooth-muscle actin antibody stain, ×40).

Reference

1. Wong RC, Solomon AR. Acquired dermal smooth-muscle hamartoma. Cutis. 1985. 35:369–370.

2. ul Bari A, Rahman SB. Acquired smooth muscle hamartoma. Indian J Dermatol Venereol Leprol. 2006. 72:178.

3. van Kooten EO, Hage JJ, Meinhardt W, Horenblas S, Mooi WJ. Acquired smooth-muscle hamartoma of the scrotum: a histological simulator? J Cutan Pathol. 2004. 31:388–392.

4. Quinn TR, Young RH. Smooth-muscle hamartoma of the tunica dartos of the scrotum: report of a case. J Cutan Pathol. 1997. 24:322–326.

5. Hsiao GH, Chen JS. Acquired genital smooth-muscle hamartoma. A case report. Am J Dermatopathol. 1995. 17:67–70.

6. Semerci B, Ilbey O, Yurtseven O. Acquired penoscrotal smooth muscle hamartoma. J Urol. 1997. 158:885–886.

7. Oiso N, Fukai K, Ishii M, Hayashi T, Uda H, Imanishi M. A case of acquired smooth muscle hamartoma of the scrotum. Clin Exp Dermatol. 2005. 30:523–524.

8. Kwon KS, Lee CW, Seo KH, Park JH, Oh CK, Jang HS, et al. Acquired vulvar smooth muscle hamartoma: a case report and review of the literature. J Dermatol. 2000. 27:56–59.

9. Morales-Callaghan A, Vila JB, Cardenal EA, Bernier MA, Fraile HA, Miranda-Romero A. Acquired cutaneous smooth muscle hamartoma. J Eur Acad Dermatol Venereol. 2005. 19:142–143.

10. Darling TN, Kamino H, Murray JC. Acquired cutaneous smooth muscle hamartoma. J Am Acad Dermatol. 1993. 28:844–845.

11. Ryu HJ, Kim G, Song HJ, Oh CH. A case of acquired cutaneous smooth muscle hamartoma. Ann Dermatol. 2002. 14:161–163.