M Asghar Ali, Iqbal G S.
Infiltrating Angiolipoma of Skeletal Muscles.
Pak J Surg Jan ;18(1):39-40.

Infiltrating angiolipoma is a rare benign condition characterized by abnormally increased vascularity. Surgery remains the mainstay of treatment. Although, benign, is associated with significant recurrence rate if not completely removed. It should, therefore, be adequately dealt with and completely removed.

A 25 years old housewife presented to us with a history of a swelling in the left iliac fossa and left inguinal region with pain of two years duration. On ex amination she had a mass about 10 x 8 cm, firm to hard in consistency, slightly tender, fixed and extending from left iliac fossa into the left inguinal region belowthe inguinal ligament. There were two scar marks of previous abortive attempts at removing this mass at some peripheral hospital that were abandoned due to excessive bleeding. Incision biopsy at one of the abortive attempts revealed an angiolipoma. CAT Scan of the abdomen and pelvis showed a large heterogeneous density mass with fat density area in it, deep to iliacus muscle extending down to its insertion. The mass was pushing the part of the iliacus muscle anterolaterally and displacing the urinary bladder, uterus and the psoas muscle medially. Surgery was planned. The incision extended along the inguinal ligament and the iliac crest. Inguinal ligament was incised at its medial attachment. Femoral vessels were identified and isolated along with the femoral nerve below the inguinal ligament. Whole of the mass and the tissue were tense and immobile. In order to relieve the tension caused by the abnormal lifting of the iliacus muscle, the muscle was incised close to its insertion. The mass was dissected out and removed along with the iliacus muscle. All the important structures were identified and safe guarded. Patient made an uneventful recovery post operatively and is free of any recurrence after 18 months of follow up.

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