We present the case of a 64-year-old woman with a subcutaneous vascular leiomyoma in the tarsal tunnel in the ankle. The patient presented with pain of several years' duration in the medial aspect of the ankle in the retromalleolar region corresponding to the tarsal tunnel and associated with a subcutaneous mass. We report the clinical manifestation, the imaging and histopathologic features, and a review of the literature. Vascular leiomyomas are part of the differential diagnosis of painful subcutaneous masses in the lower extremity.
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