{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:46:43Z","timestamp":1785836803071,"version":"3.56.0"},"reference-count":16,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T00:00:00Z","timestamp":1785801600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Am. Podiatr. Med. Assoc.","JAPMA"],"abstract":"<jats:p>Angioleiomyoma is a benign soft tissue tumor originating from the smooth muscle of vascular structures. Though relatively uncommon, it frequently occurs in the lower extremities and is often misdiagnosed due to its nonspecific clinical presentation. We report the case of a 54-year-old female with chronic posterolateral heel pain initially attributed to insertional Achilles tendinopathy and Haglund\u2019s deformity. After failure of conservative management, MRI revealed a well-circumscribed subcutaneous lesion with signal characteristics concerning for a soft tissue neoplasm. Surgical excision was performed, and histopathologic analysis confirmed a venous-type angioleiomyoma, characterized by thick-walled vascular channels and smooth muscle proliferation without atypia. Immunohistochemistry was positive for SMA, weakly positive for desmin, and ERG-positive in the vascular endothelium. The patient experienced complete symptom resolution postoperatively. Although not exceedingly rare, angioleiomyomas remain underrecognized in clinical practice, particularly in the foot and ankle, resulting in diagnostic delays averaging over five years. MRI demonstrated characteristic features described in recent literature, validating its utility in preoperative assessment. This case reinforces the importance of maintaining a broad differential when evaluating chronic, focal heel pain and supports the use of advanced imaging and histopathologic confirmation in atypical cases. Greater awareness of angioleiomyomas can help reduce diagnostic delays and improve outcomes in patients with chronic, unexplained soft tissue pain in the foot and ankle.<\/jats:p>","DOI":"10.3390\/japma116040053","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T08:02:19Z","timestamp":1785830539000},"page":"53","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Angioleiomyoma of the Hindfoot: A Rare Cause of Chronic Heel Pain"],"prefix":"10.3390","volume":"116","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-3453-077X","authenticated-orcid":false,"given":"Alec","family":"Wroblewski","sequence":"first","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hayden","family":"Bush","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4559-264X","authenticated-orcid":false,"given":"Devon","family":"Niewohner","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung Wha","family":"Kim-Shapiro","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bonvillian","sequence":"additional","affiliation":[{"name":"Atrium Health Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.3113\/FAI.2007.1021","article-title":"Angioleiomyoma with Calcification of the Heel: Report of Two Cases","volume":"28","author":"Murata","year":"2007","journal-title":"Foot Ankle Int."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"C\u00f3rdoba-Fern\u00e1ndez, A., Mir-Gil, J., D\u00edaz-Baena, C., Ballesteros-Mora, M., C\u00f3rdoba-Jim\u00e9nez, V.E., and Castro-M\u00e9ndez, A. (2025). Clinical and Demographic Aspects of Foot Angioleiomyomas: Case Reports and Systematic Review. Surgeries, 6.","DOI":"10.3390\/surgeries6030066"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Toepfer, A., Harrasser, N., Recker, M., Lenze, U., Pohlig, F., Gerdesmeyer, L., and von Eisenhart-Rothe, R. (2018). Distribution patterns of foot and ankle tumors: A university tumor institute experience. BMC Cancer, 18.","DOI":"10.1186\/s12885-018-4648-3"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"23-025","DOI":"10.7547\/23-025","article-title":"Angioleiomyoma of the foot: Clinical and functional outcomes of surgical treatment in a case series","volume":"114","author":"Ipponi","year":"2024","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Matos, M.J., Soares, S., Schwab, J.M., Tannast, M., and Seidel, A. (2025). Foot and ankle angioleiomyoma: A systematic review. BMC Musculoskelet. Disord., 26.","DOI":"10.1186\/s12891-025-08485-3"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"rjab535","DOI":"10.1093\/jscr\/rjab535","article-title":"Angioleiomyoma\u2014Rare soft tissue tumor of the foot and ankle: Review of two patients and review of the literature","volume":"2021","author":"Bodapati","year":"2021","journal-title":"J. Surg. Case Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1002\/1097-0142(19840701)54:1<126::AID-CNCR2820540125>3.0.CO;2-F","article-title":"Angioleiomyoma: A clinicopathologic reappraisal of 562 cases","volume":"54","author":"Hachisuga","year":"1984","journal-title":"Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"19013","DOI":"10.7547\/19-013","article-title":"Exophytic Angioleiomyoma on the Plantar Foot: A Case Study","volume":"110","author":"Dreyer","year":"2020","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_9","unstructured":"Weiss, S.W., and Goldblum, J.R. (2007). Soft tissue tumors. Enzinger and Weiss\u2019s Soft Tissue Tumors, Elsevier. [5th ed.]."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/S0266-7681(05)80158-5","article-title":"Vascular leiomyoma in an index finger undergoing malignant transformation","volume":"20","author":"Herren","year":"1995","journal-title":"J. Hand Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.7863\/jum.2012.31.10.1589","article-title":"Sonographic appearances of soft tissue angioleiomyomas","volume":"31","author":"Park","year":"2012","journal-title":"J. Ultrasound Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"244","DOI":"10.7547\/16-044","article-title":"Angioleiomyoma of the Lower Leg","volume":"107","author":"Sprinkle","year":"2017","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"397","DOI":"10.7547\/17-083","article-title":"Angioleiomyoma of the foot","volume":"109","author":"Moriarty","year":"2019","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"253","DOI":"10.7547\/17-218","article-title":"Angioleiomyoma (vascular leiomyoma) presenting as a pseudoaneurysm of the tibialis posterior artery","volume":"109","author":"Ciaramella","year":"2019","journal-title":"J. Am. Podiatr. Med. Assoc."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"W291","DOI":"10.2214\/AJR.07.3952","article-title":"Angioleiomyoma in soft tissue of extremities: MRI findings","volume":"192","author":"Yoo","year":"2009","journal-title":"Am. J. Roentgenol."},{"key":"ref_16","first-page":"16","article-title":"Angioleiomyoma of the Ankle: Case Report and Literature Review of a Rare Benign Soft Tissue Tumor","volume":"6","author":"Kozlov","year":"2024","journal-title":"Cureus"}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1930-8264\/116\/4\/53\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T09:09:20Z","timestamp":1785834560000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/116\/4\/53"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,4]]},"references-count":16,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,8]]}},"alternative-id":["japma116040053"],"URL":"https:\/\/doi.org\/10.3390\/japma116040053","relation":{},"ISSN":["1930-8264"],"issn-type":[{"value":"1930-8264","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,4]]}}}