Sclerotic Glomus Tumor

Journal of Cutaneous Pathology, 2009

Symplastic glomus tumor -a rare but distinct benign histological variant with analogy to other 'ancient' benign skin neoplasms A 78-year-old woman presented with a nail deformity of the index finger of the left hand associated with paroxysmal pain upon cold exposure. Histologically, a well-circumscribed tumor of 3 mm diameter was found in the dermis. The neoplastic cells in some areas were of pronouncedly variable size and cytomorphology, mostly epithelioid in shape, with eosinophilic cytoplasm and indistinctly defined cell borders. Pronounced nuclear pleomorphism and atypia were striking features, but no mitotic figures were noted. Multinuclear cells were present as were numerous small-to-medium vessels throughout the tumor. The tumor stroma showed myxoid areas. Immunohistochemistry showed cytoplasmic and membranous expression of smooth muscle actin and vimentin. The histological features and immunoprofile were consistent with the diagnosis of symplastic glomus tumor, a rare histological variant, which has been defined as a glomus tumor exhibiting marked nuclear atypia, in the absence of any other criteria for malignancy. The biological behavior of the tumor is benign. It is essential to differentiate this entity from malignant glomus tumor, which has metastatic potential. Even prominent cellular atypia and nuclear pleomorphism in a glomus tumor as in our case is not a marker of malignancy in the absence of additional criteria.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2015

Introduction Glomus tumor is a neuromyoarterial tumor. It is a rare tumor which accounts for about 2% of all hand tumors. The diagnosis is based on the triad of symptoms, clinical examination which includes three tests, magnetic resonance imaging, and ultrasound imaging. The most common treatment is surgical excision, using transungual or lateral subperiosteal approach. Sclerotherapy and radiotherapy may be the treatments of choice, but they are less effective. The recurrence rate is high -from 5% to 50%. Case Outline We diagnosed a glomus tumor of 1 cm in diameter in the distal phalanx of the fourth finger of the right hand in a 30-year-old woman. She had been visiting different physicians for more than two years and had been variously diagnosed. We performed a biopsy of the tumor, which was bleeding profusely during the procedure. Upon biopsy results, the tumor was excised with transungual approach. Two and a half months after the procedure the patient was feeling well. Conclusion There should be higher awareness of this tumor in order to diagnose it more easily and treat it accordingly, and thus alleviate the severe pain which the tumor causes. When it is considered as the possible cause of the lesion, the diagnosing is easier and treatment is immediate.

Journal of Shoulder and Elbow Surgery, 2009

Glomus tumors are a tumor of perivascular, temperatureregulating bodies; 75% occur in the hand, 50% of these are subungual, and 50% occur with erosion of the distal phalanges. They are typically less than 1 cm in diameter. The tumor may often present as a small, bluish-red nodule. Nail ridging is a common finding. Magnetic resonance imaging (MRI) is helpful in making the diagnosis. Treatment is marginal excision.

SKINmed, 2002

Background. Glomus tumor is a benign neoplasm of uncommon occurrence in daily practice, more frequently observed as a single painful lesion, at the distal phalanges of the fingers. Multiple presentation is very rare, with fewer than 200 reports, usually presenting as small angiomatous lesions with discrete pain.

International Surgery Journal, 2018

Glomangioma or glomus tumors are rare neoplasms of the glomus body, which are located in the stratum reticularis of the dermis throughout the body. With a female preponderance, 75% of them occur in the subungual region and present with non-specific pain as the main complaint. Extradigital glomus tumours are rare and present a diagnostic challenge, seen most commonly in males. We present a case of a 47-year-old male who presented with a painful swelling in the forearm. MRI showed a hypodense lesion in the subcutaneous plane. After a wide local excision, histopathology revealed sheets of round cells with intervening vascular channels, characteristic of a glomus tumor.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2003

Giant glomus tumors pose a challenge to the Otologist by virtue of their location and vascularity. A vast majority of them present with tinnitus, conductive hearing loss and cranial nerve palsies. We report the case of a 16-year-old male patient who presented with sudden right-sided sensorineural hearing loss. This is an unusual presentation of a giant glomus tumor. We present the clinical features and management of this unusual case.

Hand and Microsurgery, 2016

Aim: Glomus tumors are typically located in the subungual region in 75%-90% of patients. However, these tumors can be seen in atypical localizations which are extra-digital parts of the human body. Here, we present the management of a series of five patients with extra-digital glomus tumors treated surgically. Patients and methods: The mean age of the patients was 40.6 years. The mean duration between symptom onset and presentation was 3.6 years. The localization of the tumors were anterolaterally of the thigh, posteriorly of the humerus lateral condyle, posteriorly of the humerus supracondylar region, anteromedially of the tuberositas tibia, and on the dorsal side of the wrist. Results: The mean follow-up was at 52.8 months. For all patients, all lesions healed without any wound issues and no recurrences were noted during the follow-up period. Conclusion: When a painful mass is found in the body, glomus tumors should be kept in mind. The consideration of symptoms, including pain, temperature sensitivity, point tenderness, and discoloration, common characteristics of glomus tumors, may aid diagnosis.

Journal of Cutaneous Pathology, 1977

A man had widespread, slowly evolving vaseular lesions sinee infaney suggestive of the Blue Rubber Bleb Nevus Syndrome. His son had two painless lesions typical of Multiple Glomus Tumors. Many of the man's nodular lesions were painful. Post-excision recurrences were noted. Histologic studies ot asymptomatic tumors from both cases showed irregular, dilated, yascular channels surrounded by narrow mantles of glomus cells, whereas a painful tumor had large foci of glomus cells with wider mantles around the flattened channels. Electron microscopy showed the glomus cells to be nioditled smooth musele eells. The anatomy and pathology of glomus tumors are reviewed. Differentiation from other syndromes of muUiple hemangiomata, particularly tho Blue Rubber Bleb Nevus Syndrome is stressed. It is suggested that Multiple Glomus Tumors may be derived frorn simple eutaneous vessels and not the Sucquet-Hoyer eanal of the normal cutaneous glomus body deseribed by Masson in 1924.

International Journal of Surgical Pathology, 2012

A 41-year-old man presented with a 2-cm painful subcutaneous nodule in his right leg, which had been present for more than 10 years and was recently enlarging. Histologically, the tumor was composed of sheets and nests of cells with variable cytomorphology, including typical round/ovoid glomus cells with clear cytoplasm and well-defined borders, small cells, and spindle cells. Numerous medium to large vessels were present. Nodules with moderate to high cellularity, nuclear atypia, and frequent mitotic figures (42 per 50 high-power fields) were noted. Immunohistochemistry showed cytoplasmic and membranous expression of smooth-muscle actin, vimentin, and membranous expression of type IV collagen. Whereas superficiality, dimensions, and long-term follow-up may suggest classification as a symplastic or uncertain potential glomus tumor (GT), histological features and immunoprofile are indicative of malignant nodules developed in a typical GT. The follow-up has been negative for recurrence/metastases. A search of the literature revealed 17 cases of malignant GTs between 1995 and 2010, all fatal, of which 10 had skin as the primary site.

Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, 2018

Malignant glomus tumors are rare tumors of mesenchymal origin arising from the smooth muscle cells of the glomus body. A vast majority of the glomus tumors are benign and are commonly found in the distal extremities. Occasionally, malignant variant of glomus tumours present with a large size, infiltrative growth pattern, aggressive biological behavior such as recurrences, wide spread metastases and even death in some instances. Malignant Glomus tumors were believed to be low grade malignancies. However, from subsequently reported cases it has been evident that 38% of the MGTs have lead to fatal metastases. Malignant Glomus tumors have been reported in other organ sites like mediastinum, kidney, lungs, however their occurrence in the head and neck region is rare. This review discusses in detail about this rare but important soft tissue neoplasm.