Infiltrative glomus tumor arising from a benign glomus tumor: a distinctive immunohistochemical pattern in the infiltrative component

Relationship between dermoscopic and histopathological findings of extradigital glomus tumors

In extradigital glomus tumors, (1) noncontact and (2) contact dermoscopy show (1) a central purplish-white area corresponding to tumor nests surrounding enlarged vessels, a peripheral yellow-white area corresponding to mucin deposition, melanin granules, and fibrous tissue, and (2) white reticular and linear cord areas corresponding to pseudocapsules and collagen fibers.

Glomangiomatosis - immunohistochemical study: A case report

BACKGROUND

Glomangiomatosis (also known as diffuse glomus tumor) is extremely rare, accounting for only 5% of glomus tumors. The prevalence of glomus tumors is only 2% of soft tissue tumors. Lesions can recur after resection. Although growth may be diffuse or infiltrating and invasive, definitive identifying standards for malignant glomus tumors are lacking. This article describes a case of glomangiomatosis with many nodular masses in the soft tissues of the right foot and calf. A review of the Chinese and English-language literature is included.

CASE SUMMARY

A case of glomangiomatosis in a 55-year-old Chinese woman who presented clinically with many nodular masses in the soft tissues of the right foot and calf. The tumor was examined histologically and immunostaining was performed.

CONCLUSION

Glomangiomatosis occurs most often in young people, in the distal extremities, but is rare. Multiple nodules are even rarer. Only 15 clinicopathological analyses of glomangiomatosis have been reported in the combined Chinese- and English-language literature. In the present case, microscopically, nested vascular globular cells were observed around the blood vessel wall. Immunohistochemistry revealed diffuse immunoreactivity for smooth muscle actin, vimentin, type IV collagen, and Bcl-2. Caldesmon, CD34, and calponin were weakly, partially, and slightly positive, respectively. There was no recurrence 1 year after resection.

The glomus tumor resorbed bone and teeth in the mandible: a case report

BACKGROUND

A glomus tumor is a rare neoplasm usually found in the dermis or subcutaneous tissue of the extremities. It is rare for the glomus tumor to occur on the head and face. Only 26 glomus tumors of the oral region and affected bone have been reported in the English-language literature (Table 1). We report a case of a glomus tumor at the mandible. As a new point, the glomus tumor resorbed a bone and teeth roots when the tumor progressed into the mandible.

CASE PRESENTATION

The patient was a 44-year-old Japanese man who complained swelling of the right mandible. Radiographic examination showed a multilocular radiolucency area in the left mandible. Radiographic findings on our case resembled those of a common benign tumor. The lesion occupied to the premolar and molar area and revealed that the tumor resorbed the roots of the teeth. The lesion was removed surgically with the buccal cortical bone and buccal mucosa in contact with the mass of the tumor. The mass fully excised intraorally under general anesthesia, and the inferior alveolar nerve in contact with the mass was preserved. The specimen was pathologically diagnosed as a glomus tumor. Immunohistochemical staining was positive for vimentin, muscle-specific actin/HHF35, and calponin. A hairline-shaped area of positive staining for type IV collagen surrounding the tumor cells was also observed. In contrast, staining for alpha-SMA, cytokeratin (AE1/AE3), cytokeratin (CAM5.2), CK19, CD31, CD34, CD68, p63, S-100, Factor VIII, and desmin was all negative. The Ki-67 labeling index was almost 1%. A recurrent tumor was again detected in the site below the primary tumor at an 8-year follow-up, and it was surgically removed. The patient has had no symptoms of recurrence in 2 years after the second operation.

CONCLUSION

The glomus tumor resorbed a bone and teeth roots when the tumor progressed into the mandible. The immunohistochemical features of the tumor were consistent with those described in previous reports. It is important to completely remove the Glomus tumor.

Multiple Glomus Tumors of the Omentum

A glomus tumor is a very rare neoplasm consisting of cells that resemble the modified smooth muscle cells of normal glomus bodies. Here, we report a case of a 39-year-old male with multiple omental glomus tumors. The patient underwent a complete resection of the glomus tumors. This is a rare case of omental glomus tumors, and to our knowledge, this patient is the first with multiple omental glomus tumors to be described.

Malignant glomus tumor of the palm: a case report

The author herein reports on a glomus tumor of the palm. A 71-year-old man consulted our hospital because of a tumor on the left palm. The tumor was deeply seated, and MRI and CT showed a deep cystic tumor adjacent to the bone. An excision of the tumor was therefore performed. Grossly, the tumor was red and partly cystic. The tumor was well defined from the surrounding tissues, and measured 25 × 24 × 22 mm. Microscopically, the tumor consisted of epithelioid perivascular cells (glomus cells) located around the blood vessels. Cystic changes and hyalinization areas were scattered. The tumor cells had moderately hyperchromatic nuclei. Nuclear pleomorphism was noticed, nucleoli were absent and apparent mitotic figures were not recognized. There were no areas of necrosis. Immunohistochemically, the glomus cells were positive for vimentin and α-smooth muscle actin. They were negative for cytokeratins, epithelial membrane antigen, CD34, CD31, factor VIII-related antigen, S100 protein, p53 protein, desmin and melanosome. The Ki-67 labeling was 5%. The tumor was diagnosed as a malignant glomus tumor because of its deep location and size > 2 cm , according to the criteria of one group. The tumor recurred 12 months later, and a further excision was performed. No metastases were found. Now, the patient is being strictly followed up.

CD34-positive expression in benign nasal glomus tumour: two case reports and a literature review

Nasal glomus tumours are extremely rare neoplasms with poorly understood histogenesis, but which are clinically recognized as benign. The neoplastic cells of glomus tumours resemble normal glomus cells and are arranged around a varying number of thin-walled, sometimes branching, capillaries. CD34 is known to be a marker of tumour progenitor cells. In this report, two cases of benign nasal glomus tumour are presented. The tumours were excised completely via endoscopic endonasal surgery under local anaesthesia. During surgery, there was little bleeding and the post-surgical course for both patients was uneventful. Tumour cells from both cases were positive for α-smooth muscle actin, actin, vimentin and CD34 protein. Thus, CD34 positivity against a background of other immunohisto chemical markers is helpful in the differential diagnosis of glomus tumours.

Paravertebral glomangiomatosis

Glomangiomatosis is benign but may manifest as diffusely, locally infiltrating lesions and recur after simple excision. However, conservative treatment should be advocated. The authors report a recent case in which the lesion occurred in the paravertebral area. The patient was a 39-year-old Chinese man who complained of chronic lumbago for 20 years. The clinicopathological features, in conjunction with the immunostaining pattern and ultrastructural features, confirmed the diagnosis. Glomangiomatosis is an extremely rare soft-tissue lesion. To the best of authors' knowledge, only 10 cases have been reported in the English-language literature worldwide, and the current case is the first to represent a lesion arising from the paravertebral area. The authors review the English-language literature in glomangiomatosis.

Glomus tumor and glomangioma of the nerve. Report of two cases

As a rule, normal human nerve does not contain glomus bodies. Nonetheless, rare examples of glomus tumors do arise in peripheral nerves of various sizes. Their pathobiological characteristics are poorly understood, but reported examples have been small and clinically benign. The authors identified in 1 patient each a glomus tumor and a glomangioma involving nerve. Clinical histories as well as imaging and surgical findings were reviewed. All available H & E-stained slides were examined in both cases. Immunohistochemical stains and electron microscopy, as appropriate, were also performed. The lesions were subtotally and completely resected, respectively. An uneventful postoperative recovery was noted in both patients. Glomus tumors and glomangiomas can involve major nerves on rare occasions. They seem to follow a favorable clinical course, and conservative resection can be of benefit.

Glomus tumor of the kidney: a report of 3 cases involving renal parenchyma and review of the literature

Glomus tumor is a rare mesenchymal neoplasm affecting the subcutaneous tissue of the distal extremities in the majority of cases. It only rarely involves visceral organs. We report 3 cases of the glomus tumor family in the kidney, a solid glomus tumor, a glomangioma, and a glomangiomyoma. All 3 tumors involved the renal parenchyma and occurred in 3 men aged 36, 81, and 48 years, respectively. All 3 tumors were well-circumscribed and showed morphology otherwise identical to those seen in soft tissue. All 3 tumors were immunoreactive for actin and negative for desmin and S100 and only 1 tumor expressed CD34 in tumor cells. To date, all 3 tumors have followed a benign course without evidence of recurrence or metastasis. This report expands the spectrum of mesenchymal tumors of the kidney.

Malignant Glomus Tumor

Malignant glomus tumor (MGT) is a rare, recently described neoplasm that recapitulates the appearance of the modified smooth cells of the normal glomus body. We report a case of MGT of the hand of a 48-year-old woman. Magnetic resonance imaging (MRI) showed a 2.8-cm, well circumscribed, enhancing mass on the volar aspect of the thenar region of the right hand in immediate continuity with the ulnar artery and nerve. Computed tomography scan (CT-Scan) of the chest was normal. Histologic evaluation revealed a multilobular lesion with prominent branching capillary vasculature and perivascular arrangement of sheets of tumor cells. The tumor cells were round, relatively uniform in size with distinct cell borders and perinuclear cytoplasmic clearing. They were of intermediate to high nuclear grade and showed significant mitotic activity. A wide local excision with negative margins was performed. Multiple lung metastases were evident at 8-month follow-up. To date, forty-five cases of MGT of skin and soft issue have been reported in the literature. Twelve of the forty-five cases developed metastasis. In this report, we emphasize the differential diagnosis of MGT in the skin and deep soft tissue.

Glomangiosarcoma of the hand: a case report and review of the literature

Glomangiosarcomas, or malignant glomus tumors, are very rare, cutaneous, soft tissue tumors. Despite having histologic features of malignancy, these tumors usually do not metastasize. We describe a 74-year-old woman with a glomangiosarcoma on her hand and review the literature. The woman presented with a five month history of a painful mass on the right palm. An excisional biopsy of the mass was undertaken. Histologically, the tumor was composed of uniform, round cells and numerous vascular components. The tumor cells were pleomorphic and had large nucleoli. Frequent mitotic figures were identified. Immunohistochemical stains showed strong positivity for vimentin and weak, focal positivity for smooth muscle actin. Ultrastructurally, the tumor cells were characterized by pinocytic vesicles, well formed basal lamina, and scattered junctional complex of the plasma membrane.

Familial generalized multiple glomangiomyoma: report of a new family, with immunohistochemical and ultrastructural studies and review of the literature

Glomus tumors are benign lesions which often appear as solitary bluish nodules. They can also be multiple, and can be either acquired or congenital. Histopathologically glomus tumors are classified into three different variants: solid glomus tumor, glomangioma, and glomangiomyoma, which is the least frequent type. We report three instances of familial generalized multiple glomangiomyoma in a woman and her two children. Seven members of the family in two consecutive generations were affected, suggesting autosomal dominant inheritance. We performed a thorough clinical study, complete blood and platelet counts, stool for occult blood, karyotype, abdominal echography (which showed an asymptomatic solitary hepatic vascular lesion in one of the patients), gastrointestinal endoscopy, and skin biopsy with immunohistologic and ultrastructural studies. We believe that the terms glomangioma and glomangiomyoma actually designate the same lesion, with transitional areas from typical glomus cells to well-defined conventional smooth muscle cells. Although complete evaluation should be performed in all patients with multiple glomus tumors in order to detect possible occult systemic lesions, we only recommend treatment for symptomatic lesions. To our knowledge, this is the first report of an instance of familial multiple glomangiomyoma.