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Kransdorf MJ, Larsen BT, Fox MG, Murphey MD, Long JR. Musculoskeletal glomus tumor: a review of 218 lesions in 176 patients. Skeletal Radiol 2024:10.1007/s00256-024-04743-y. [PMID: 39078477 DOI: 10.1007/s00256-024-04743-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/26/2024] [Accepted: 06/27/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVE To review the spectrum of clinical and imaging features of glomus tumor involving the musculoskeletal system including the typically solitary forms as well as the rarer multifocal forms (glomuvenous malformation and glomangiomatosis). MATERIALS AND METHODS A retrospective review of our institutional pathology database from 1996 to 2023 identified 176 patients with 218 confirmed glomus tumors. Primary imaging studies included MRI (125), radiographs (100), clinical/intraoperative photos (77), and ultrasound (36). Lesions were divided into two groups: those that are typically solitary involving specific anatomic areas (finger, toe, soft tissue, coccyx, and bone), and those that are multifocal (glomuvenous malformation and glomangiomatosis). RESULTS The finger was the most frequently involved anatomic location for the classic (sporadic) glomus tumor occurring in 51% of patients, 77% of which were women, with the nail plate involved in more of the 75% of cases. Sporadic lesions involving the skin, subcutaneous adipose tissue, and deep soft tissue were termed "soft tissue," and were identified in 39% of patients, 90% of which were in the extremities and in men in 81% of cases. The multifocal syndromic forms of glomus disease occurred in younger individuals and involved less than 6% of the study group. Patients with glomuvenous malformation presented early with predominantly cutaneous involvement, while those with glomangiomatosis present later, often with both superficial and deep involvement, and a high rate of local tumor recurrence. CONCLUSION While glomus tumor is generally uncommon, it frequently involves the musculoskeletal extremities. Knowledge of the spectrum of characteristic locations and appearances will facilitate definitive diagnosis.
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Affiliation(s)
- Mark J Kransdorf
- Department of Radiology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA.
| | - Brandon T Larsen
- Department of Pathology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA
| | - Michael G Fox
- Department of Radiology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA
| | - Mark D Murphey
- ACR Institute for Radiologic Pathology (AIRP), 1100 Wayne Avenue, Suite 1020, Silver Spring, MD, 20910, USA
- Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA
- Department of Radiology, Walter Reed National Military Medical Center, 8901 Wisconsin Ave., Bethesda, MD, 20889, USA
| | - Jeremiah R Long
- Department of Radiology, Mayo Clinic, 5777 E Mayo Boulevard, Phoenix, AZ, USA
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Neder AT, da Costa AC, de Barros RSM, Nakachima LR, Rodrigues MP, de Souza SCA, de Oliveira RK, da Gama SAM, Sabongi RG, Hirakawa CK. Hand tumors. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e2024S108. [PMID: 38865528 PMCID: PMC11164264 DOI: 10.1590/1806-9282.2024s108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 12/11/2023] [Indexed: 06/14/2024]
Affiliation(s)
- Antonio Tufi Neder
- Universidade de São Paulo/Faculty of Medicine of Ribeirão Preto - Hand Surgery at Rede Mater Dei de Saúde and Instituto Orizonti – Belo Horizonte (MG), Brazil
| | - Antonio Carlos da Costa
- Medical School of Santa Casa de São Paulo, Hand Surgery and Microsurgery Group at Santa Casa de São Paulo – Belo Horizonte (MG), Brazil
| | | | - Luis Renato Nakachima
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Orthopedics and Traumatology – Belo Horizonte (MG), Brazil
| | - Mauricio Pinto Rodrigues
- Universidade de São Paulo, Institute of Orthopedics and Traumatology, Clinical Hospital, Faculty of Medicine – Belo Horizonte (MG), Brazil
| | | | | | - Sérgio Augusto Machado da Gama
- Universidade de São Paulo, Clinical Hospital, Faculty of Medicine, Pontifícia Universidade Católica de Campinas Hand Group – Belo Horizonte (MG), Brazil
| | - Rodrigo Guerra Sabongi
- Universidade Federal de São Paulo, Paulista School of Medicine – Belo Horizonte (MG), Brazil
| | - Celso Kiyoshi Hirakawa
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Orthopedics and Traumatology – Belo Horizonte (MG), Brazil
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Matsumoto S, Okumura T, Miwa T, Numata Y, Hamashima T, Ito M, Nagaoka Y, Takeshita C, Sakai A, Kimura N, Fukasawa M, Mori K, Takeda N, Yagi K, Muranushi R, Manabe T, Shirai Y, Watanabe T, Hirano K, Hashimoto I, Shibuya K, Yoshioka I, Fujii T. Thoracoscopic enucleation of an esophageal glomus tumor in the prone position: a case report and literature review. Surg Case Rep 2024; 10:131. [PMID: 38805072 PMCID: PMC11133250 DOI: 10.1186/s40792-024-01934-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Glomus tumors (GT) generally occur in the skin. However, esophageal GT, an extremely rare condition, has no established standardized treatment guidelines. Herein, we report the case of an esophageal GT successfully removed by thoracoscopic enucleation in the prone position using intra-esophageal balloon compression. CASE PRESENTATION A 45-year-old man underwent an annual endoscopic examination and was found to have a submucosal tumor in the lower esophagus. Endoscopic ultrasound (EUS) revealed a hyperechoic mass originating from the muscular layer. Contrast-enhanced computed tomography identified a 2 cm mass lesion with high contrast enhancement in the right side of the lower esophagus. Pathologic findings of EUS-guided fine needle aspiration biopsy (EUS-FNA) revealed round to spindle shaped atypical cells without mitotic activity. Immunohistochemically, the tumor was positive for alpha-smooth muscle actin, but negative for CD34, desmin, keratin 18, S-100 protein, melan A, c-kit, and STAT6. He was diagnosed with an esophageal GT and a thoracoscopic approach to tumor resection was planned. Under general anesthesia, a Sengstaken-Blakemore (SB) tube was inserted into the esophagus. The patient was placed in the prone position and a right thoracoscopic approach was achieved. The esophagus around the tumor was mobilized and the SB tube balloon inflated to compress the tumor toward the thoracic cavity. The muscle layer was divided and the tumor was successfully enucleated without mucosal penetration. Oral intake was initiated on postoperative day (POD) 3 and the patient discharged on POD 9. No surgical complications or tumor metastasis were observed during the 1-year postoperative follow-up. CONCLUSIONS As malignancy criteria for esophageal GT are not yet established, the least invasive procedure for complete resection should be selected on a case-by-case basis. Thoracoscopic enucleation in the prone position using intra-esophageal balloon compression is useful to treat esophageal GT on the right side of the esophagus.
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Affiliation(s)
- Shigeki Matsumoto
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Tomoyuki Okumura
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
- Office of Human Research Ethics, Faculty of Education and Research Promotion, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Takeshi Miwa
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yoshihisa Numata
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Takeru Hamashima
- Department of Pathology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Miki Ito
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yasuhiro Nagaoka
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Chitaru Takeshita
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Ayano Sakai
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Nana Kimura
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Mina Fukasawa
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Kosuke Mori
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Naoya Takeda
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Kenta Yagi
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Ryo Muranushi
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Takahiro Manabe
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Yoshihiro Shirai
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Toru Watanabe
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Katsuhisa Hirano
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Isaya Hashimoto
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Kazuto Shibuya
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Isaku Yoshioka
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
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Falcone MO, Asmar G, Chassat R. Subungual glomus tumor. HAND SURGERY & REHABILITATION 2024; 43S:101607. [PMID: 37866479 DOI: 10.1016/j.hansur.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
Subungual glomus tumors arise from the glomus body of the digits. They are rare and benign and often in a single location. Their diagnosis relies on the typical clinical triad of symptoms and on imaging findings, mainly magnetic resonance imaging with gadolinium injection. Subungual tumors treatment is complete resection, essential for cure. The different surgical techniques aim to: a painless digit with normal range of motion and sensitivity, without nail deformity after tumour resection, and to recurrence prevention. They vary according to tumor location. Classic surgical approaches are: the nail unit sparing ones (para-ungual, lateral subperiosteal, periungual), and the nail unit non-sparing ones (all transungual approaches with nail bed splitting). In this paper, we review the literature for the different approaches describing the advantages and drawbacks of each of them. We also describe the author's preferred subperiosteal "shark mouth" flap containing the nail plate and the nail bed as a single unit. It can be performed whether the tumor is located centrally, peripherally, or under the germinal matrix with very satisfactory outcomes.
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Affiliation(s)
- Marc-Olivier Falcone
- Clinique Jouvenet, Capio - Ramsay Santé, 6 Square Jouvenet, 75016 Paris, France; Hôpital Privé Paul d'Egine, Capio - Ramsay Santé, 4 Avenue Marx Dormoy, 94500 Champigny sur Marne, France.
| | - Ghada Asmar
- Hôpital Privé Paul d'Egine, Capio - Ramsay Santé, 4 Avenue Marx Dormoy, 94500 Champigny sur Marne, France
| | - Romain Chassat
- Hôpital Privé de l'Ouest Parisien, Capio - Ramsay Santé, 14 Rue Castiglione Del Lago, 78190 Trappes, France
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Al-Janabi MH, Abdallah G, Deeb H, Melhem F, Salloum R. Extradigital glomus tumor: A rare case report. Int J Surg Case Rep 2024; 116:109466. [PMID: 38442675 PMCID: PMC10926113 DOI: 10.1016/j.ijscr.2024.109466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/25/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Glomus tumors are benign soft tissue tumors of the glomus body, most regularly found in the sublingual region of the digits, palms, and soles. Extra digital lesions are uncommon and might be difficult to diagnose. CASE PRESENTATION We report a rare case of a 38-year-old man who presented with a painful nodule on his right upper arm. A definite diagnosis was made by histopathological study. A complete surgical excision was performed to avoid recurrence. CLINICAL DISCUSSION Glomus tumors form less than 2 % of all soft tissue tumors. The tumor was first reported by Wood in 1812. It typically appears like a small blue-red solitary papule in the hand especially the digits, which are the most prevalent location for glomus tumors with an incidence rate of up to 75 %. The histopathology findings of glomus tumor, are three components: glomus cells, vasculature, and smooth muscle cells. The preferred method of treatment is total excision to prevent a recurrence. CONCLUSION Eventually, the glomus tumor is fairly a rare benign tumor that physicians should keep in mind as a deferential diagnosis when facing a subcutaneous nodule and don't rule out when the tumor is extradigital.
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Affiliation(s)
| | - Ghina Abdallah
- Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Hasan Deeb
- Faculty of Medicine, Tishreen University, Lattakia, Syria
| | - Firas Melhem
- Department of Plastic Surgery, Tishreen University Hospital, Lattakia, , Syria
| | - Rabab Salloum
- Department of Pathology, Tishreen University Hospital, Lattakia, Syria
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Trajkovski G, Trajkovska V, Kostadinova-Kunovska S, Kostovski O, Gelevski R, Nikolovski A. Low-grade malignancy glomus tumor of the abdominal wall: a case report and literature review. J Surg Case Rep 2023; 2023:rjad680. [PMID: 38115948 PMCID: PMC10728413 DOI: 10.1093/jscr/rjad680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023] Open
Abstract
Glomus tumors are painful neoplasms arising from the glomus body (responsible for body temperature and blood pressure regulation) in the skin. Although mostly present in the interdigital areas, glomus tumors can arise elsewhere. The vast majority of them are benign. Rarely, malignant variants are reported and are associated with the potential for local infiltration and metastatic dissemination. The abdominal wall location of glomus tumors is extremely rare regardless of whether they present as benign or malignant. We present a case of a 58-year-old female patient with a low-grade malignancy infiltrative glomus tumor of the abdominal wall.
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Affiliation(s)
- Gjorgji Trajkovski
- University Clinic Digestive Surgery, Clinical Center “Mother Theresa”, 1000 Skopje, North Macedonia
- Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia
| | - Vanja Trajkovska
- Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia
- University Clinic for Traumatology, Orthopedic Disease, Anesthesiology, Reanimation and Intensive Care and Emergency Department, Clinical Center “Mother Theresa”, 1000 Skopje, North Macedonia
| | - Slavica Kostadinova-Kunovska
- Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia
- Faculty of Medicine, Institute of Pathology, 1000 Skopje, North Macedonia
| | - Ognen Kostovski
- University Clinic Digestive Surgery, Clinical Center “Mother Theresa”, 1000 Skopje, North Macedonia
- Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia
| | - Radomir Gelevski
- Faculty of Medicine, Institute of Pathology, 1000 Skopje, North Macedonia
| | - Andrej Nikolovski
- Ss. Cyril and Methodius University in Skopje, 1000 Skopje, North Macedonia
- Department of Visceral Surgery, University Surgery Hospital “St. Naum Ohridski” 1000 Skopje, North Macedonia
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Ahangar P, Akbaribazm M, Rahimi M, Pirmohamadi H. Modified nail folding approach: A novel strategy for the treatment of subungual glomus tumors-A case series study. Clin Case Rep 2023; 11:e8129. [PMID: 37915733 PMCID: PMC10616360 DOI: 10.1002/ccr3.8129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/10/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023] Open
Abstract
Key Clinical Message The modified nail folding approach, a new surgical technique, has been shown to be safe and effective for the treatment of subungual glomus tumors, providing clinicians with a new treatment option for patients with this condition. Abstract Glomus tumors (GTs) are rare benign tumors that originate from the glomus body in the skin of the fingertips, toes, and nail beds. GTs are more prevalent in women than in men and can occur sporadically or as part of an inherited condition known as multiple GTs. The exact cause of GTs is unknown, but it is believed that mutations in the cells of the glomus body contribute to their development. In this study, we present the efficacy of a novel surgical technique called the modified nail folding approach for treating subungual GTs. We report a case series involving 17 patients who underwent the nail folding approach for surgical removal of subungual GTs. The primary objective of this article is to provide evidence supporting the safety and effectiveness of this technique. Additionally, we aim to introduce clinicians to a new, secure, and efficient treatment option for patients with subungual GTs.
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Affiliation(s)
| | - Mohsen Akbaribazm
- Department of Basic Medical SciencesKhoy University of Medical SciencesKhoyIran
| | - Mohsen Rahimi
- Health Research Center, Life Style InstituteBaqiyatallah University of Medical SciencesTehranIran
| | - Hosein Pirmohamadi
- Trauma Research CenterBaqiyatallah University of Medical SciencesTehranIran
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Takanashi N, Asai S, Ogase Y, Fujii A, Atsumi H, Doi M, Kumaki N, Mabuchi T, Miyachi H. Ultrasonographic Characteristics in the Fingers and Other Superficial Glomus Tumours. Dermatol Res Pract 2023; 2023:7126799. [PMID: 37546347 PMCID: PMC10397493 DOI: 10.1155/2023/7126799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/04/2023] [Accepted: 07/17/2023] [Indexed: 08/08/2023] Open
Abstract
Glomus tumours are painful superficial tumours, and ultrasonography is an extremely useful and noninvasive diagnostic technique for superficial organs. In this study, we retrospectively examined glomus tumours using ultrasonography. Among 18 patients histopathologically diagnosed with glomus tumours via ultrasonography, we observed five different development sites: subungual areas or those surrounding the nail bed (12), other areas on the finger surface (3), abdominal wall (1), upper arm (1), and forearm (1). The ultrasonographic images revealed significant differences in tumour size, indicating that tumours on other body surfaces tended to be smaller than those on patients' fingers (p < 0.01). The depth/width ratios of tumours on the other body surfaces were significantly higher than those on the fingers (p < 0.05). The tumours showed a regular shape (72.2%) and clear border (100%). Furthermore, most tumours were low-echo tumours with a diameter of up to 15 mm, clear margins, and no lateral shadows. Abundant blood flow and vessels in and out of the tumours were also observed. In conclusion, our study describes the ultrasonographic characteristics of glomus tumours and reveals that they cannot be ruled out when diagnosing small painful subcutaneous tumours.
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Affiliation(s)
- Noboru Takanashi
- Department of Clinical Laboratory Technology, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Satomi Asai
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Yoko Ogase
- Department of Clinical Laboratory Technology, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Akiko Fujii
- Department of Clinical Laboratory Technology, Tokai University Hospital, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Haruyo Atsumi
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Mika Doi
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Nobue Kumaki
- Department of Pathology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Tomotaka Mabuchi
- Department of Dermatology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
| | - Hayato Miyachi
- Department of Laboratory Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1196, Japan
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Abidin MA, Kitta MI, Nong I, Rahmansyah N, Johan MP. Diagnosis and surgical approach in treating glomus tumor distal phalanx left middle finger: A case report. Int J Surg Case Rep 2023; 108:108426. [PMID: 37392587 PMCID: PMC10382771 DOI: 10.1016/j.ijscr.2023.108426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 07/03/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Glomus tumors are rare mesenchymal neoplasms. These tumors originate from the glomus bodies and are commonly found in the fingertips, especially in the subungual location. The cause of this tumor is unknown. Clinically, the symptoms are non-specific and often not identified on physical examination and radiologically accompanied by rare cases, making it difficult to diagnose a glomus tumor. CASE PRESENTATION Current report present a case of pain at the tip of the middle finger of the left hand in a woman for six years and worsening in the last two years. The patient has visited several doctors with analgesic therapy, but the complaints have not improved. A bluish nail was found on physical examination, and a clinical study with the Love's pin test and the Hildreth test had positive results. Radiographic examination showed destruction with cortical thinning of the medial aspect of the distal phalanx of the left middle finger, and MRI showed a lesion with an erosion of the distal middle finger. In this case, complete surgical excision and biopsy were performed using a transungual surgical approach. The sample was sent for microscopic examination, showing a glomus tumor. CLINICAL DISCUSSION Cases with clinical symptoms of intense paroxysmal pain, exquisite point tenderness, and sensitivity to cold allow a clinical diagnosis in 90 % of cases. On clinical examinations such as Love's pin test, Hildreth's test, cold sensitivity test, and trans-illumination test with positive results and confirmed by MRI or ultrasound, the diagnosis of glomus tumor can be established. CONCLUSION This case shows a glomus tumor in the distal phalanges of the middle finger of the left hand-diagnosis enforcement through detailed history taking and physical examination, confirmed by MRI and microscopic examination. Complete surgical excision is an effective treatment. In this case, using a transungual surgical approach based on preoperative MRI, the subungual lesion was found to provide the best exposure.
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Affiliation(s)
- Moh Asri Abidin
- Medical Faculty of Muhammadiyah University, Makassar, Indonesia.
| | - Muh Ihsan Kitta
- Medical Faculty of Muhammadiyah University, Makassar, Indonesia; Department of Orthopaedic and Traumatology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia
| | - Ira Nong
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia
| | - Nur Rahmansyah
- Medical Faculty of Bosowa University, Makassar, Indonesia
| | - Muhammad Phetrus Johan
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo General Hospital, Makassar, Indonesia
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10
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Cohen PR. Glomus Extradigital Tumor: A Case Report of an Extradigital Glomus Tumor on the Wrist and Comprehensive Review of Glomus Tumors. Cureus 2023; 15:e38737. [PMID: 37292537 PMCID: PMC10247156 DOI: 10.7759/cureus.38737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2023] [Indexed: 06/10/2023] Open
Abstract
A glomus tumor is a neoplasm composed of cells from the glomus body which is a contractile neuromyoarterial structure that affects blood pressure and thermoregulation by altering cutaneous blood flow. This cutaneous tumor can be benign or rarely malignant, solitary or multiple, and digital or extradigital. A benign glomus tumor usually presents as a non-familial, solitary, and subungual lesion. Multiple glomus tumors are less common, may be autosomal dominantly inherited, and extradigital. In contrast to a digital glomus tumor that often occurs within the nailbed or fingertip pulp of a young woman, a glomus extradigital tumor (GET) typically appears on the extremity or trunk of an older man. The diagnosis of a glomus tumor may be suspected based on clinical evaluation; it classically presents with a clinical triad of symptoms which includes lesion-associated tenderness, pin-point pressure pain, and cold sensitivity. However, cold-induced exacerbation of pain is frequently absent in extradigital glomus tumors; this may contribute to a delay in establishing the diagnosis of a glomus tumor in these individuals. Radiographic studies can support the diagnosis, but tissue specimen examination is necessary to establish the diagnosis. Resolution of tumor-associated pain is usually achieved following the complete excision of the neoplasm. A woman with a glomus tumor located on her wrist is described; her painful tumor was not sensitive to cold and was misdiagnosed clinically as a possible foreign body reaction to either a wood splinter or glass shard. The diagnosis of an extradigital glomus tumor was established after a microscopic examination of the tissue specimen following an excisional biopsy using a 3-millimeter punch biopsy tool. The neoplasm-related pain ceased and did not recur after the tumor had been completely removed. In conclusion, a glomus tumor is included in the differential diagnosis of a painful cutaneous neoplasm; however, misdiagnosis and/or substantial delay in diagnosis may occur if the tumor is extradigital or it lacks cold sensitivity or both. Therefore, the clinician needs to entertain the possibility of an extradigital glomus tumor when evaluating a patient with a tender, temperature-insensitive skin lesion that is not located on the fingers or toes.
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Affiliation(s)
- Philip R Cohen
- Dermatology, University of California, Davis Medical Center, Sacramento, USA
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Orman O, Onal A, Baydar M, Sencan A, Özkan B, Öztürk K. Comparison of Subungual Glomus Tumours in Terms of Nail Aesthetics and Recurrence According to Size and Location in the Germinal or Sterile Matrix. HANDCHIR MIKROCHIR P 2023; 55:35-40. [PMID: 36070778 DOI: 10.1055/a-1759-3253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The aim of this retrospective study was to investigate the effect of subungual glomus tumour size and localization in the germinal or sterile matrix on tumour recurrence and aesthetic outcomes. PATIENTS AND METHODS From 35 patients who underwent surgery for a subungual glomus tumour between February 2013 and February 2020, 26 patients - 17 women and 9 men - with 27 subungual glomus tumours fulfilled the inclusion criteria. The average age was 37.3 (22-58) years. According to the patients' surgical notes and preoperative magnetic resonance images 14 tumours were located in the sterile, 13 in the germinal matrix, and the mean size of the glomus tumours located in the germinal matrix was 4.9±1.7 mm, in the sterile matrix 3.6±1.0 mm. At the postoperative 12th month follow-up visit nail aesthetic was evaluated objectively according to Zook's fingernail appearance scoring. In addition, patients were asked to evaluate the pain and nail appearance in the involved finger by VAS (Visual Analog Scale 0-10). Patients who experienced recurrence were noted. RESULTS No significant Zook's fingernail appearance score differences were observed between germinal and sterile matrix groups (p=0.097). Comparison of VAS score for pain and VAS score for nail appearance between the two groups also yielded similar values (p=0.449 and 0.395, respectively). The recurrence rate was similar at both locations (p=0.557) with 3 recurrences in the germinal, and 2 in the sterile matrix group. There was no relation between tumour size, Zook's fingernail appearance score (p=0.874) and recurrence (p=0.784). The observed germinal matrix glomus tumours were significantly larger than the sterile matrix tumours (p=0.031). CONCLUSION Neither subungual glomus tumour size nor localization in the germinal or sterile matrices has different effects on nail appearance and recurrence.
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Affiliation(s)
- Osman Orman
- Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Hand Surgery Clinic
| | - Ayberk Onal
- Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Hand Surgery Clinic
| | - Mehmet Baydar
- Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Hand Surgery Clinic
| | - Ayse Sencan
- Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Hand Surgery Clinic
| | - Bilge Özkan
- Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Hand Surgery Clinic
| | - Kahraman Öztürk
- Metin Sabanci Baltalimani Kemik Hastaliklari Egitim ve Arastirma Hastanesi Hand Surgery Clinic
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12
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Muacevic A, Adler JR. A Malignant Glomus Tumor of the Liver Harboring MIR143-NOTCH2 Rearrangement: From Diagnosis to Management. Cureus 2022; 14:e30718. [PMID: 36439569 PMCID: PMC9696860 DOI: 10.7759/cureus.30718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2022] [Indexed: 01/25/2023] Open
Abstract
A primary malignant glomus tumor of the liver is extremely rare and diagnostically challenging. We present an exceptional case of such with a diagnosis confirmed by MIR143-NOTCH2 rearrangement. The case was successfully managed with neoadjuvant chemotherapy followed by surgery. This report highlights the utilization of molecular analysis to aid in the diagnosis of rare soft tissue malignancies and supports a multimodality approach to the treatment of large, high-grade malignant glomus tumors.
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13
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Singal A, Bisherwal K, Agrawal S, Bhat S, Diwakar P. Clinico‐epidemiological
profile and management outcome of
subungual
digital glomus tumor—Indian experience. Dermatol Ther 2022; 35:e15745. [DOI: 10.1111/dth.15745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Archana Singal
- Department of Dermatology & STD University College of Medical Sciences & GTB Hospital (University of Delhi) Delhi India
| | - Kavita Bisherwal
- Department of Dermatology & STD University College of Medical Sciences & GTB Hospital (University of Delhi) Delhi India
| | - Sonia Agrawal
- Department of Dermatology & STD University College of Medical Sciences & GTB Hospital (University of Delhi) Delhi India
| | - Shuchi Bhat
- Department of Radiodiagnosis University College of Medical Sciences & GTB Hospital (University of Delhi) Delhi India
| | - Preeti Diwakar
- Department of Pathology University College of Medical Sciences & GTB Hospital (University of Delhi) Delhi India
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14
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Chen X, Zhou G, Xue H, Wang R, Bird S, Sun D, Cui L. High-Resolution Ultrasound of the Forefoot and Common Pathologies. Diagnostics (Basel) 2022; 12:diagnostics12071541. [PMID: 35885448 PMCID: PMC9322853 DOI: 10.3390/diagnostics12071541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/21/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
Forefoot pain is common in clinical practice. Careful history taking and routine physical examination are initially performed for diagnosis, but imaging can confirm the clinical suspicion and play a key role in management. Ultrasound (US) can provide a visualization of the fine anatomy of the forefoot and is a useful method for evaluating various lesions causing forefoot pain. In this review, we provide the detailed anatomical structures of the forefoot and their normal appearances on US. We also focus on the most common pathologies affecting the forefoot, including plantar plate tear, sesamoiditis, bone fracture, synovitis, tenosynovitis, bursitis, Morton’s neuromas, and foreign bodies.
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Affiliation(s)
- Xiangmei Chen
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518036, China; (X.C.); (R.W.)
| | - Guangjin Zhou
- Department of Radiology, Peking University Third Hospital, Beijing 100191, China;
| | - Heng Xue
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China;
| | - Run Wang
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518036, China; (X.C.); (R.W.)
| | | | - Desheng Sun
- Department of Ultrasound, Peking University Shenzhen Hospital, Shenzhen 518036, China; (X.C.); (R.W.)
- Correspondence: (D.S.); (L.C.); Tel.: +86-(13)-510331808 (D.S.); +86-(15)-611908349 (L.C.)
| | - Ligang Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China;
- Correspondence: (D.S.); (L.C.); Tel.: +86-(13)-510331808 (D.S.); +86-(15)-611908349 (L.C.)
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15
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Yeom JA, Jeong YJ, Ahn HY, Eom JS, Lee CH, Hwang MH. Tracheal Glomus Tumor: A Case Report with CT Imaging Features. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58060791. [PMID: 35744054 PMCID: PMC9229945 DOI: 10.3390/medicina58060791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/05/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Glomus tumors are rare benign tumors. The majority of them affect the skin the most and are rarer in the trachea, where the glomus bodies may not be present. Only scarce reports of tracheal glomus tumors have been reported solely with case reports of relevant articles. MATERIALS AND METHODS A 53-year-old man, with a free previous medial history, presented to our hospital with tracheal mass which was incidentally found. He did not complain of any specific symptoms associated with the tracheal tumor. The contrast-enhanced chest computed tomography (CT) revealed an avid enhancing nodular lesion, which is similar to blood vessels, in the trachea, 3 cm above the carina level without definite airway obstruction. RESULTS Successful tracheal resection and end-to-end anastomosis were performed on the patients; therefore, the final post-operative pathologic findings revealed a benign tracheal glomus tumor. The follow-up CT scan four months after operation showed complete removal of the tumor. CONCLUSION Tracheal glomus tumors, even rare entities, could be considered as a differential diagnosis if a highly enhancing mass appears on CT images.
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Affiliation(s)
- Jeong-A Yeom
- Department of Radiology, Pusan National University Yangsan Hospital, Yangsan-si 50612, Korea;
| | - Yeon-Joo Jeong
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea;
| | - Hyo-Yeong Ahn
- Department of Thoracic and Cardiovascular Surgery, Medial Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea;
| | - Jung-Seop Eom
- Department of Internal Medicine, Pusan National University School of Medicine, Busan 49241, Korea;
| | - Chang-Hun Lee
- Department of Pathology, Medial Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea;
| | - Min-Hee Hwang
- Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Korea;
- Correspondence:
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16
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Zhang E, Miller A, Clinton C, DeSmith K, Voss SD, Aster JC, Church AJ, Rahbar R, Eberhart N, Janeway KA, DuBois SG. Gamma Secretase Inhibition for a Child With Metastatic Glomus Tumor and Activated NOTCH1. JCO Precis Oncol 2022; 6:e2200099. [PMID: 35731997 DOI: 10.1200/po.22.00099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Amber Miller
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Catherine Clinton
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Kylene DeSmith
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Stephan D Voss
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Jon C Aster
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Alanna J Church
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Reza Rahbar
- Department of Otolaryngology, Boston Children's Hospital and Harvard Medical School, Boston, MA
| | | | - Katherine A Janeway
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Steven G DuBois
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
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17
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Guedes GVC, Jácome DT, Alves GF, Monteiro AV. Epidemiological Analysis of Glomus Tumors of the Hand and Association with Recurrence Rate. REVISTA IBEROAMERICANA DE CIRUGÍA DE LA MANO 2022. [DOI: 10.1055/s-0042-1744466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Abstract
Introduction Glomus tumors are benign, characterized by microvascular alteration, and mostly found in the subungual region of the hand. They are rare and associated with paroxysmal pain, tenderness on palpation, and thermal sensitivity. The aim of the present research was to analyze the epidemiology of glomus tumors and relate each of the variables with cases of recurrence.
Materials and Methods A retrospective review of medical records was undertaken in our hospital to collect epidemiological numerical variables (time between the onset of symptoms and diagnosis and surgery, age, size of the tumor on magnetic resonance imaging and the histopathological examination, time until recurrence and reoperation after surgery, duration of the follow-up) and categorical variables (gender, ethnicity, laterality, affected finger, location in the hand, surgical technique, smoking, preoperative symptoms, recurrence, and comorbidities). Then, we performed a statistical analysis to identify possible associations of the hand tumors with recurrences.
Results The review identified 66 patients with glomus tumors 52 of which were located in the hand. The mean age of the sample was 49 years, and it was mostly composed of white female patients. Pain was the main related symptom, and most tumors presented sizes between 5 mm and 1 cm. Among the 52 patients, 11 cases presented recurrences, with a mean time until onset of 39.4 months, but 3 of them were initially operated on at other hospitals. None of the variables was shown to be a predictor of recurrence, although we saw that bone involvement on radiographs was only present in certain cases of recurrence.
Conclusion The sample studied was large for this rare disease, and reinforced previous results regarding its epidemiology. As 54% of the cases of recurrence occurred at least twice, we think that genetic, histological and immunohistochemical analyses should be the focus of futures studies, as well as a search for bone and tendon involvement.
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Affiliation(s)
- Giovanni Vilardo Cerqueira Guedes
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Instituto Nacional de Traumatologia e Ortopedia Jammil Haddad (INTO), Rio de Janeiro, RJ, Brazil
| | - Daniel Torres Jácome
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Instituto Nacional de Traumatologia e Ortopedia Jammil Haddad (INTO), Rio de Janeiro, RJ, Brazil
| | - Gabriel Farias Alves
- Department of Orthopedics and Traumatology, Instituto Nacional de Traumatologia e Ortopedia Jammil Haddad (INTO), Rio de Janeiro, RJ, Brazil
| | - Anderson Vieira Monteiro
- Division of Hand Surgery, Department of Orthopedics and Traumatology, Instituto Nacional de Traumatologia e Ortopedia Jammil Haddad (INTO), Rio de Janeiro, RJ, Brazil
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18
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Kimura T, Kubota M, Hattori H, Saito M. Simultaneous Glomus Tumors of the Third and Fourth Toes: A Case Report. JBJS Case Connect 2022; 12:01709767-202206000-00028. [PMID: 36099526 DOI: 10.2106/jbjs.cc.21.00780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A glomus tumor of the toes is rare, and as far as we know, there has been no report of simultaneous occurrence in 2 toes. A 45-year-old woman presented with forefoot pain. Based on imaging findings, glomus tumors of the third and fourth toes were suspected. Tumor resection was performed, and pathological examination confirmed the diagnosis of glomus tumors. CONCLUSION In this case, it was difficult to recognize the tumors because they occurred simultaneously in 2 toes. Even for sites where a glomus tumor is rare, it is important to understand the characteristic symptoms through a detailed interview and examination.
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Affiliation(s)
- Tadashi Kimura
- Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan
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19
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Ge J, Zhang D, Xue Z, Lu M, Yin Y, Lu X. Glomus Tumors of the Distal Phalanx: A Retrospective Review of Clinical Diagnosis and Treatment. Orthopedics 2022; 45:e101-e106. [PMID: 35021033 DOI: 10.3928/01477447-20220105-03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Glomus tumors (GTs) are rare and typically occur in distal digital bones, with a majority of cases comprising benign vascular tumors. The current study retrospectively reviewed 10 cases of GTs treated by the authors between January 2009 and December 2016. In 9 cases, the GTs were subungual; 1 case was periungual. The affected fingers included 2 thumbs, 3 index fingers, 3 middle fingers, and 2 little fingers. The GTs showed characteristic signs and symptoms. All patients underwent tumor excision. Pathological examination found a thin layer of fibrous membrane surrounding the excised tumor body, which contained small vessels surrounded by multilayered tumor cells. No recurrence was seen during follow-up. The results of this study suggested the following: (1) whole tumor excision is key to preventing GT recurrence; and (2) in case of considerable phalangeal cortex erosion, K-wire fixation followed by autogenous bone grafting can produce satisfactory outcomes, although accurate evidence-based indications for this management need to be established. [Orthopedics. 2022;45(2):e101-e106.].
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20
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Hwang J, McDowell S, Cole B, Huber A, Reyes MCD. Cytologic analysis of a glomus tumor in the left second toe: Case report. Diagn Cytopathol 2022; 50:E170-E173. [PMID: 35137564 DOI: 10.1002/dc.24942] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Revised: 01/13/2022] [Accepted: 01/25/2022] [Indexed: 11/11/2022]
Abstract
We present a 66-year-old female with a glomus tumor diagnosed by fine-needle aspiration (FNA) at the subungual region of her left second toe. Cytologic findings include cohesive clusters of round, uniform cells with scant cytoplasm. Nuclei were monotonous with fine chromatin. No cellular atypia, nuclear inclusions, mitotic figures, nor nucleoli were identified. Cells were surrounded by thick wisps of magenta colored myxoid material reminiscent of a pleomorphic adenoma. Few spindle shaped cells could be seen near the border of the tumor clusters. Staining was positive for alpha-smooth muscle actin. This case report presents one of few FNA diagnosed glomus tumors.
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Affiliation(s)
- Jay Hwang
- University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Susan McDowell
- Department of Orthopedics, University of Rochester School of Medicine & Dentistry, Rochester, New York, USA
| | - Bradley Cole
- Department of Diagnostic Radiology, Ide Imaging Partners, Inc., Rochester, New York, USA
| | - Aaron Huber
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, New York, USA
| | - Maria Cecilia D Reyes
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
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21
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Wieser ME, Gilley DR, May JG, Rivera AL. A rare case of a middle ear glomangioma. SAGE Open Med Case Rep 2022; 10:2050313X211070520. [PMID: 35024149 PMCID: PMC8744075 DOI: 10.1177/2050313x211070520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 12/14/2021] [Indexed: 11/17/2022] Open
Abstract
Glomus tumors are benign hyperplasia of glomus bodies, and they are rarely found in the head and neck. The middle ear is an exceptionally rare site for a true glomus tumor, and there are only three previously reported cases in this location. Glomus tumors are etiologically different than glomus tympanicum, which are paragangliomas of the middle ear that are often mistakenly referred to as “glomus tumors.” This is a common misconception due to the “glomus” misnomer. We report a case of a patient diagnosed with a middle ear glomangioma after initially presenting to our clinic with tinnitus and hearing loss. The mass was surgically removed through a transcanal approach with carbon dioxide laser and sharp dissection. Literature review is also reported and revealed similar presentations in patients with middle ear glomangiomas.
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Affiliation(s)
- Margaret E Wieser
- Degree Program, University of Missouri School of Medicine, Columbia, MO, USA
| | - David R Gilley
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO, USA
| | - Jason G May
- Department of Otolaryngology-Head and Neck Surgery, Children's Mercy Hospital, Kansas City, MO, USA
| | - Arnaldo L Rivera
- Department of Otolaryngology-Head and Neck Surgery, University of Missouri School of Medicine, Columbia, MO, USA
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22
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Mani B, Priyadarshini A, Rajesh G, Sankarasubramanian A. Glomus tumor presenting as atypical tender papule on the lower limb. JOURNAL OF DERMATOLOGY & DERMATOLOGIC SURGERY 2022. [DOI: 10.4103/jdds.jdds_58_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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23
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Cheng Y, Tang H, Wu ZB. Sellar Glomus Tumor Misdiagnosed as Pituitary Adenoma: A Case Report and Review of the Literature. Front Endocrinol (Lausanne) 2022; 13:895054. [PMID: 35600590 PMCID: PMC9114742 DOI: 10.3389/fendo.2022.895054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
Glomus tumor is a rare mesenchymal tumor with an organ-like structure. Sellar glomus tumors are extremely rare with only six reported cases in the literature. Because of the lack of special clinical manifestations and imaging features, the disorder may be easily misdiagnosed as other sellar tumors, especially pituitary adenomas. Here, the present study showed a case of a 69-year-old male with hypopituitarism who was preliminarily misdiagnosed as non-functional pituitary adenoma.
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Nguyen L, Kim BS, Besmens I, Pastor T, Vasella M, Huber N, Rebecchini C, Frueh FS, Calcagni M, Guidi M. An atypical localization of glomus tumor in the leg. Case Reports Plast Surg Hand Surg 2021. [DOI: 10.1080/23320885.2021.2003710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Lynhda Nguyen
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bong-Sung Kim
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Inga Besmens
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Tatjana Pastor
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Mauro Vasella
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Nora Huber
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Caterina Rebecchini
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Florian S. Frueh
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Maurizio Calcagni
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Marco Guidi
- Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland
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25
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Rodriguez JD, Selleck AM, Abdel Razek AAK, Huang BY. Update on MR Imaging of Soft Tissue Tumors of Head and Neck. Magn Reson Imaging Clin N Am 2021; 30:151-198. [PMID: 34802577 DOI: 10.1016/j.mric.2021.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This article reviews soft tissue tumors of the head and neck following the 2020 revision of WHO Classification of Soft Tissue and Bone Tumours. Common soft tissue tumors in the head and neck and tumors are discussed, along with newly added entities to the classification system. Salient clinical and imaging features that may allow for improved diagnostic accuracy or to narrow the imaging differential diagnosis are covered. Advanced imaging techniques are discussed, with a focus on diffusion-weighted and dynamic contrast imaging and their potential to help characterize soft tissue tumors and aid in distinguishing malignant from benign tumors.
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Affiliation(s)
- Justin D Rodriguez
- Department of Radiology, Duke University, 2301 Erwin Rd, Durham, NC 27705, USA
| | - A Morgan Selleck
- Department of Otolaryngology/Head and Neck Surgery, University of North Carolina Hospitals, 170 Manning Drive, CB 7070, Physicians Office Building, Rm G190A, Chapel Hill, NC 27599, USA
| | | | - Benjamin Y Huang
- Department of Radiology, UNC School of Medicine, 101 Manning Drive, CB#7510, Chapel Hill, NC 27599, USA.
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26
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Garcia LC, Fernandes ENDS, Sobreira NDP, Bittencourt FV. Extradigital glomus tumor: dermoscopic description and histopathological correlation. An Bras Dermatol 2021; 96:765-767. [PMID: 34563419 PMCID: PMC8790217 DOI: 10.1016/j.abd.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/17/2022] Open
Abstract
Glomus tumors are rare benign neoplasms arising from the neuromyoarterial structure called glomus body. They present as angiomatous papules, soft and painful, especially to cold and pressure. In general, they are solitary and affect the extremities, located mainly the subungual bed. Extradigital lesions are rare and can constitute a diagnostic challenge. This is the report of a patient with an extradigital lesion on the left arm, and its dermoscopic aspects, including angiomatous lagoons circumscribed by a pale halo, a structure not previously described in the two reports of extradigital glomus tumor with dermoscopic features, found in the literature.
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Affiliation(s)
- Lucas Campos Garcia
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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27
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Minimally Invasive Transungual Tumors Enucleation With Nail Preservation for Subungual Glomus Tumors. Dermatol Surg 2021; 47:e138-e141. [PMID: 33587379 DOI: 10.1097/dss.0000000000002847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Glomus tumors are benign neurovascular neoplasms, most commonly located in the subungual region. These subcutaneous nodules are characterized by intense pain and temperature sensitivity. Although surgical excision is the curative treatment, permanent nail deformity and recurrence are not uncommon after conventional surgery. OBJECTIVE This study evaluated the long-term efficacy of a modified transungual approach with nail preservation for removing subungual glomus tumors. MATERIAL AND METHODS Thirty-nine patients with clinically diagnosed and histopathologically proven glomus tumors treated at a medical center over a 13-year period (2007-2019) were retrospectively evaluated. RESULTS The 39 patients included 28 women and 11 men (ratio, 2.5:1), with a mean age of 48.9 years. Thirty-four tumors were located in the fingers and 5 in the toes. All patients returned to normal activity soon after the surgery. At a mean follow-up of 28.8 months, all were pain free or experienced minimal pain and were satisfied with treatment outcomes. One patient (2.6%) experienced recurrence. No nail deformity was observed. CONCLUSION The transungual approach with nail plate preservation is a novel and effective method for removing subungual glomus tumors with reduced postoperative pain and rapid healing, while preserving or improving the configuration of the nail.
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Hernández V, Lena T, Camacho E, Craviotto M. Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years. REVISTA IBEROAMERICANA DE CIRUGÍA DE LA MANO 2021. [DOI: 10.1055/s-0041-1730392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.
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Affiliation(s)
- Victoria Hernández
- Plastic, Reconstructive and Esthetic Surgery Resident, Hospital de Clínicas Dr. Manuel Quintela, Plastic Surgery Department, Montevideo, Uruguay
| | - Tania Lena
- Plastic surgeon, Hospital Central de las Fuerzas Armadas, Montevideo Uruguay
| | - Eliana Camacho
- Plastic, Reconstructive and Esthetic Surgery Resident, Hospital de Clínicas Dr. Manuel Quintela, Plastic Surgery Department, Montevideo, Uruguay
| | - Matías Craviotto
- Plastic surgeon, Hospital Central de las Fuerzas Armadas, Montevideo Uruguay
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Glomus Tumor: "A-Not-So-Rare" Cause of Chronic Shoulder Pain-A Case Report and Literature Review. Case Rep Orthop 2021; 2021:6666092. [PMID: 34136298 PMCID: PMC8175186 DOI: 10.1155/2021/6666092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 05/10/2021] [Indexed: 02/07/2023] Open
Abstract
Case A 61-year-old male presented with chronic shoulder pain resistant to conservative treatment. Imaging identified a nodular lesion in the deltoid muscle, which histology after resection identified as a glomus tumor. After surgery, the patient became asymptomatic and at 4-year follow-up has not shown signs of recurrence. Conclusion Glomus tumors around the shoulder should be considered when investigating chronic shoulder pain, as they are more common than thought. Despite being elusive, when diagnosed, excellent outcomes may be expected, with surgery resection being curative.
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Dege T, Wobser M, Goebeler M, Reichel A. [Pressure sensitive livid node on the left knee]. Hautarzt 2021; 72:1116-1118. [PMID: 33942153 DOI: 10.1007/s00105-021-04827-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Tassilo Dege
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland.
| | - Marion Wobser
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - Matthias Goebeler
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
| | - Alexandra Reichel
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Deutschland
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Berlinberg EJ, Markus DH, Jour G, Strauss EJ. Prepatellar Glomus Tumor of the Knee without an Identifiable Mass on MRI: A Case Report. JBJS Case Connect 2021; 11:01709767-202106000-00025. [PMID: 33979812 DOI: 10.2106/jbjs.cc.19.00433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 71-year-old man presented with extreme anterior knee pain. His history, physical examination, and imaging were consistent with prepatellar bursitis, but his pain seemed out of proportion for these findings. The patient eventually underwent marginal excision of the inflamed prepatellar bursa which histopathology identified as a glomangioma. Postoperatively, he has complete resolution of his pain and has returned to his daily activities. CONCLUSION Glomus tumors are a rare cause of severe knee pain that completely resolves after excision. In the patient with extreme, localized knee sensitivity, it is important to consider this pathology even if no mass is identified on imaging.
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Affiliation(s)
- Elyse J Berlinberg
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
| | - Danielle H Markus
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
| | - George Jour
- Department of Pathology, NYU Langone Medical Center, New York, New York
| | - Eric J Strauss
- Department of Orthopaedic Surgery, NYU Langone Medical Center, New York, New York
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Çevik HB, Çiçek ÇA, Kayahan S, Gümüstas SA, Filinte GT. Glomus tumors of the upper extremity. HANDCHIR MIKROCHIR P 2021; 53:72-75. [PMID: 33588493 DOI: 10.1055/a-1333-2459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Glomus tumors are uncommon and painful benign perivascular neoplasms. They usually occur in the subungual region of phalanx, and present with a classic clinical triad of localized tenderness, cold hypersensitivity, and excruciating paroxysmal pain. The aim of this study was to review 45 cases of glomus tumor according to the clinical, radiological and therapeutic characteristics, and the clinical and functional outcomes of surgical treatment. MATERIALS AND METHODS A retrospective review was made of 45 glomus tumors of the upper extremity operated on between June 2005 and January 2019. Data were collected of demographic characteristics and the diagnostic, immunohistochemical, therapeutic and postoperative clinical findings. RESULTS The patients comprised 69 % females and 31 % males with a median age of 41 years at the time of surgery. The most commonly affected anatomic location was the digits (87 %). Of the 39 cases with an affected digit, there was a predominance of the middle finger in 28 % and the peri-subungual area in 51 %. There was no recurrence or need for secondary surgical intervention in any patient in this study. The mean QuickDASH score was 1.47 at mean 66 months follow-up. CONCLUSIONS Glomus tumor, which is usually seen in the middle finger of middle-aged women, presents with excruciating paroxysmal pain out of proportion to the tumor size. The long-term outcomes after surgical loupe-assisted surgery with a transungual approach were seen to be good, without local recurrence and an acceptable rate of postoperative nail dystrophy.
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Affiliation(s)
- Hüseyin Bilgehan Çevik
- Ankara Diskapi Yildirim Beyazit, Training and Research Hospital, Orthopaedics and Traumatology
| | - Çagla Amutkan Çiçek
- Istanbul Dr Lufti Kirdar Kartal Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery
| | - Sibel Kayahan
- Istanbul Dr Lufti Kirdar Kartal Training and Research Hospital, Pathology
| | - Seyit Ali Gümüstas
- Istanbul Dr Lufti Kirdar Kartal Training and Research Hospital, Orthopaedics and Traumatology
| | - Gaye Taylan Filinte
- Istanbul Dr Lufti Kirdar Kartal Training and Research Hospital, Plastic, Reconstructive and Aesthetic Surgery
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Lira-Valero FJ, Guevara-Castillo RM, Pulido-Díaz N, Quintal-Ramírez MDJ. Long-term telangiectatic nodule in left shoulder. JAAD Case Rep 2021; 10:38-40. [PMID: 33732845 PMCID: PMC7941071 DOI: 10.1016/j.jdcr.2020.12.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Francisco Javier Lira-Valero
- Department of Dermatology, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México City, México
| | - Rosa María Guevara-Castillo
- Department of Dermatology, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México City, México
| | - Nancy Pulido-Díaz
- Department of Dermatology, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México City, México
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Sparks DD, Wu Q, Falcone TE. An Unusual Nasal Septal Lesion in an Adult Patient. JAMA Otolaryngol Head Neck Surg 2021; 146:300-301. [PMID: 31830208 DOI: 10.1001/jamaoto.2019.3836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | - Qian Wu
- Pathology and Laboratory Medicine, University of Connecticut School of Medicine, Farmington
| | - Todd E Falcone
- Division of Otolaryngology-Head and Neck Surgery, University of Connecticut School of Medicine, Farmington
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Ziegler A, Thorpe E. Pediatric Malignant Glomus Tumor of the Cervical Paraspinal Tissue: Case Report and Review of the Literature. JOURNAL OF PEDIATRIC NEUROLOGY 2020. [DOI: 10.1055/s-0040-1721402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AbstractGlomus tumors are mesenchymal tumors that arise from glomus bodies and most frequently occur in the distal extremities. These tumors can occur throughout the body and are typically benign. However, a very small fraction of glomus tumors displays aggressive features and are considered atypical or malignant. We report on our experience and management of the first case in the literature of a malignant glomus tumor in a child originating in the paraspinal region with involvement of the cervical spine. Malignant glomus tumors tend to be locally aggressive, and en bloc resection is difficult, especially when the tumors occur in the head and neck. Additional studies on disease progression and adjuvant treatment outcomes are necessary to determine the best treatment approach and long-term outcomes in patients with malignant glomus tumors.
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Affiliation(s)
- Andrea Ziegler
- Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, Unites States
| | - Eric Thorpe
- Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, Unites States
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ElSherif M, Abonnour M. Outcome of transungual surgical approach with synthetic nail shield in the treatment of digital glomus tumors: A retrospective study. JPRAS Open 2020; 26:69-75. [PMID: 33195786 PMCID: PMC7644807 DOI: 10.1016/j.jpra.2020.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 09/27/2020] [Indexed: 11/29/2022] Open
Abstract
Glomus tumor is a benign neuromyoarterial tumor commonly found in the hand, particularly in the subungual region, that is removed only by surgery. Surgical excision leaves postoperative nail deformity and may cause a recurrence of subungual glomus tumors. A retrospective chart review was performed to assess the role of a synthetic nail shield in the prevention of postoperative nail deformity after transungual glomus tumor excision; the review was performed at a minimum of one year of follow-up of proven diagnosed 19 patients with digital glomus tumor between May 2011 and April 2016 in the orthopedic department in the university hospitals. All patients underwent surgical excision using transungual approach with a synthetic nail shield under digital nerve block anesthesia. Pain, cold intolerance, and complications were examined before and after surgery, and data were recorded. All patients had pain, tenderness, and cold intolerance, 12 patients (63.2%) had nail discoloration, and 3 patients (15.8%) had dystrophic changes. The tumors detached from surrounding tissues had an ovoid or round shape of 2-10 mm in size. Diagnosis was confirmed after pathological examination. In all patients, pain and cold sensitivity diminished. The mean follow-up period was 20.6 months, with no recurrences detected and improved nail appearance. No patient had postoperative nail deformity. Transungual approach followed by artificial coverage was an effective method for the treatment of glomus tumors without complications to the nail bed.
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Affiliation(s)
- M ElSherif
- Orthopedic Surgery Department, Faculty of Medicine, Suez Canal University, 4.5 Km, Ring Road, Ismailia 41111, Egypt
| | - M Abonnour
- Egyptian Ministry of Health, Cairo, Egypt
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Wood TR, McHugh JB, Siegel GW. Glomus tumors with malignant features of the extremities: a case series. Clin Sarcoma Res 2020; 10:20. [PMID: 33133513 PMCID: PMC7596933 DOI: 10.1186/s13569-020-00142-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 10/22/2020] [Indexed: 12/01/2022] Open
Abstract
Background Malignant glomus tumors are exceedingly rare, however they can be locally aggressive and have the potential to metastasize. There is limited information available in the literature regarding treatment and outcomes, therefore we present a case series of 5 patients with glomus tumors with malignant features confined to the extremities that have presented to our tertiary sarcoma center within the last 20 years. This is the largest case series of its kind in the malignant glomus tumor literature, to our knowledge. Methods We performed a retrospective chart review of all patients with histologically confirmed glomus tumors with malignant features in the extremities found within the University of Michigan EMERSE database since January 1st, 2000. Results Five patients met our inclusion and exclusion criteria. Three patients were diagnosed with malignant glomus tumors, one patient with glomus tumor with uncertain malignant potential, and the last patient with malignant glomus tumor with leiomyosarcomatous features. Males and females were equally represented. Age range was 9–49 years at time of first presentation. All patients underwent an initial surgical resection. Three of the five patients (60%) underwent initial resection at an outside hospital prior to referral to tertiary sarcoma center, and all three required re-resection. One of these patients had local tumor recurrence after a planned positive margin resection and radiotherapy. Another patient had distant metastasis after a positive margin surgical resection and a short course of radiotherapy. All patients are still alive according to their medical record with the average time from initial treatment to last follow up of 59.2 months. Conclusions Our study supports the current literature that wide-local resection with the goal of negative margins is still the current gold standard treatment for glomus tumors with malignant features. Studies with larger cohorts are necessary before recommending for or against radiotherapy or chemotherapy. Early biopsy and referral to a tertiary sarcoma center prior to surgical resection may help reduce the re-resection rate and potential seeding of the tumor in these patients, thereby improving outcomes.
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Affiliation(s)
- Taylor R Wood
- Michigan Medicine, Rogel Cancer Center, Floor B1, Reception C, 1500 E Medical Center Dr., SPC 5912, Ann Arbor, MI 4810 USA
| | - Jonathan B McHugh
- Michigan Medicine, Rogel Cancer Center, Floor B1, Reception C, 1500 E Medical Center Dr., SPC 5912, Ann Arbor, MI 4810 USA
| | - Geoffrey W Siegel
- Michigan Medicine, Rogel Cancer Center, Floor B1, Reception C, 1500 E Medical Center Dr., SPC 5912, Ann Arbor, MI 4810 USA
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Lahouel M, Lahouel I, Soua Y, Ben Hamouda M, Njima M, Youssef M, Zili J. Clinical and Dermoscopic Features of an Extradigital Glomus Tumor of the Back. Dermatol Pract Concept 2020; 10:e2020077. [PMID: 33150023 DOI: 10.5826/dpc.1004a77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2020] [Indexed: 10/31/2022] Open
Affiliation(s)
- Maha Lahouel
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Ines Lahouel
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Yosra Soua
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Mouna Ben Hamouda
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Manel Njima
- Department of Pathology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Monia Youssef
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
| | - Jameleddine Zili
- Department of Dermatology, CHU Fattouma Bourguiba, Monastir, Tunisia
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Chen L, Gao YH, Chen J, Yao YJ, Wang R, Yu Q, Hu B, Jiang LX. Diagnosis of Subungual Glomus Tumors with 18 MHz Ultrasound and CDFI. Sci Rep 2020; 10:17848. [PMID: 33082509 PMCID: PMC7575557 DOI: 10.1038/s41598-020-74774-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 09/30/2020] [Indexed: 01/08/2023] Open
Abstract
To evaluate the imaging features of subungual glomus tumors using 18 MHz high-frequency ultrasound with CDFI (Color Doppler Flow Imaging). 20 patients treated by surgical resection and examined by ultrasound between January 2008 and December 2019. All eligible cases are divided into two groups: Group A used the probe frequency of 9–14 MHz from January 2008 to December 2014, and Group B used the probe frequency of 18 MHz from January 2015 to December 2019. Patient demographics, clinical records, pathologic specimens and sonography features were reviewed. 50% of tumors in Group A and 100% of tumors in Group B showed clear boundary and regular shape. Blood flow signals were identified inside 50% tumors in Group A (3 in 6), all 14 cases with blood flow signals detected in Group B (14 in 14,100%). 2 cases were misdiagnosed and 1 case escaped diagnosis in Group A, no case was misdiagnosed in Group B. The accuracy of diagnosis rate of Group B is significantly higher than that of Group A. 18-MHz ultrasound combined with CDFI may be a practical useful tool for detecting subungual glomus tumors. More importantly 18-MHz ultrasound can obviously improve the diagnostic accuracy.
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Affiliation(s)
- Li Chen
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Yi-Hui Gao
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Jie Chen
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Yi-Jing Yao
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Rui Wang
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Qian Yu
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China
| | - Bing Hu
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
| | - Li-Xin Jiang
- Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai Institute of Ultrasound in Medicine, Shanghai, China.
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Glomus tumor-induced lower extremity pain: A case report. Int J Surg Case Rep 2020; 75:352-356. [PMID: 32992093 PMCID: PMC7522039 DOI: 10.1016/j.ijscr.2020.09.093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/12/2020] [Accepted: 09/12/2020] [Indexed: 11/22/2022] Open
Abstract
Glomus tumor is a rare small benign perivascular tumor, which develops from the glomus body located in the reticular dermis. The pain caused by glomus tumor could be easily mistaken to lower extremity pain whether it is radiating, sciatic, or just a localized one. A localized thermoregulator subcutaneous tumor could generate paroxysmal pain and sensitivity to pressure which is feigned as chronic radiating pain. A thorough examination is the key to a proper diagnosis of uncommon locations of the tumor.
Introduction Glomus tumor located in the lower limb could be easily mistaken as lower extremity pain whether it is radiating, sciatic, or just a localized one. This could lead to misdiagnosis and improper management. Presentation of case This case reported a 56-year-old man complaining of pain in his left thigh. The pain was characterized as sharp and sometimes radiated to the skin of the calf muscles region. There was no history of trauma. Physical examination of the left thigh region revealed a small and barely palpable deep subcutaneous mass. Ultrasound examination showed a 6 × 5.3 mm partly cystic subcutaneous mass in the posteromedial region of the left distal femur. Doppler USG showed that the blood flow in the cystic lesion originated from the medial genicular artery. Surgical tumor excision through the medial femoral approach exposed a 15 × 10 × 5 mm yellowish-white thin encapsulated subdermal tumor attached to the vascular wall. Histopathology examination resulted in a Glomus Tumor. Discussion Glomus tumor usually occurs in areas that are rich in glomus bodies. Thigh is not a specific location for glomus bodies. It presented as bluish small nodule that are sensitive to touch and temperature changes. Glomus tumors in the thigh region rarely recurs since they are solitary and encapsulated, making them easily recognizable from the surrounding tissue during the operation. Conclusion Meticulous history taking, physical examination, and imaging modalities are necessary to differentiate between tumor and non-tumor lesions in less common areas.
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Batra V, Batta NS, Gupta A. Giant glomus tumor of the knee mimicking soft-tissue sarcoma. INDIAN JOURNAL OF MUSCULOSKELETAL RADIOLOGY 2020; 2:82-86. [DOI: 10.25259/ijmsr_9_2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Glomangiomas (glomus tumors) are benign vascular tumors commonly located at the distal extremities, are usually subungual lesions, and account for 2% of all soft-tissue tumors. Patients with digital glomus tumors present with hypersensitivity to cold, paroxysmal severe pain, and point tenderness. These tumors are infrequent in the knee area, and when seen are superficial, usually have a diameter of less than 1 cm, which make their radiological diagnosis arduous. We report a noteworthy, unusual case of a large glomus tumor in the popliteal fossa showing biceps femoris infiltration, in a 51-year-old female patient who experienced severe intermittent posterior knee pain for the past 2 years. Magnetic resonance imaging revealed a large popliteal inhomogeneous soft-tissue lesion with irregular margins insinuating the posterolateral musculature mimicking soft-tissue sarcoma. Histopathology revealed a glomus tumor.
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Affiliation(s)
- Vikas Batra
- Department of Radiology, Mahajan Imaging, Sports Injury Center, Safdarjung Hospital, New Delhi, India,
| | - Nafisa Shakir Batta
- Department of Radiology, Mahajan Imaging, Sports Injury Center, Safdarjung Hospital, New Delhi, India,
| | - Ankur Gupta
- Department of Radiology, Mahajan Imaging, Sports Injury Center, Safdarjung Hospital, New Delhi, India,
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Asmar G, Mati T, Pop IA, Falcone MO. The 'shark mouth' flap approach for digital glomus tumours in 24 patients: technique and clinical outcomes. J Hand Surg Eur Vol 2020; 45:153-159. [PMID: 31414608 DOI: 10.1177/1753193419867049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This retrospective, single-centre study was carried out on patients with digital subungual glomus tumours. We describe a subperiosteal approach with a 'shark mouth' flap containing the nail plate and nail bed as a single unit, providing ideal exposure and easy access to the tumour. It combines the advantages of the transungual and lateral approaches, whether the subungual tumours are located centrally, peripherally or under the germinal matrix. The 'shark mouth' flap approach was used by the same surgeon in 24 patients with solitary glomus tumours of the fingers. Clinical outcomes at the early postoperative phase and at the last follow-up were satisfactory. Pain relief and wound healing were quickly achieved. No complications, such as fingertip numbness or nail deformities, were observed, and there was only one recurrence. This approach is reliable, nail-sparing and less time-consuming than other techniques. Level of evidence: IV.
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Affiliation(s)
- Ghada Asmar
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France
| | - Tahar Mati
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France
| | - Ioana Anastasia Pop
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France
| | - Marc-Olivier Falcone
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France.,Clinique Internationale du Parc Monceau, Paris, France
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Reinders EF, Klaassen KM, Pasch MC. Transungual Excision of Glomus Tumors: A Treatment and Quality of Life Study. Dermatol Surg 2020; 46:103-112. [DOI: 10.1097/dss.0000000000002006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kaufman AC, Brant JA, Luu NN, LiVolsi VA, Bigelow DC. Recurrent glomangioma ("true" glomus tumor) of the middle ear and mastoid. World J Otorhinolaryngol Head Neck Surg 2019; 5:175-179. [PMID: 32083243 PMCID: PMC7015857 DOI: 10.1016/j.wjorl.2019.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/30/2018] [Accepted: 01/08/2019] [Indexed: 11/28/2022] Open
Abstract
Objective To review current literature and experience with glomangiomas, or true glomus tumors of the middle ear and mastoid as well asto report on the exceptionally rare case of a glomangiomastemming from the middle ear space with multiple recurrences. Methods Review of existing world literature and description of personal experience with rare cases of a glomangioma of the middle ear and mastoid. Results Review of existing literature revealed two cases of patients presenting with tinnitus and hearing loss refractory to medical management. Both patients were ultimately diagnosed with glomangioma on histopathology. Complete surgical excision is thought to be curative. Patient A 36-year-old woman presented with a rare case of a glomangioma of the middle ear presenting with unilateral hearing loss. She was noted to have a mass behind the tympanic membrane. Imaging revealed a diffuse mass filling the mastoid air cells. Imaging characteristics and histology were consistent with a glomangioma. Intervention Initial resection via mastoidectomy using a postauricular approach. The tympanic membrane was reconstructed with temporalis tissue. Follow-up revision tympanomastoidectomy was performed upon recurrence of disease. The chorda tympani were sacrificed due to tumor involvement. The incus and head of the malleus were removed to gain better access to the tumor. The ossicular chain was reconstructed with a Goldenberg Total Ossicular Prosthesis. Main outcome measure Recurrence of disease. Follow-up In the 67 months since her most recent surgery, there has been no evidence of recurrence by CT or physical exam. Conclusion Glomangioma of the middle ear represents an exceptionally rare entity that can present in a similar fashion to a paraganglioma.
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Affiliation(s)
- Adam C Kaufman
- Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Jason A Brant
- Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Neil N Luu
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Virginia A LiVolsi
- Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Douglas C Bigelow
- Department of Otorhinolaryngology Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Prero MY, Gener M, Taboada EM, Oermann CM. Endobronchial Glomus Tumor in a Child. PEDIATRIC ALLERGY IMMUNOLOGY AND PULMONOLOGY 2019; 32:163-166. [PMID: 32140287 DOI: 10.1089/ped.2019.1065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 09/01/2019] [Indexed: 11/12/2022]
Abstract
Glomus tumors (GTs) are rare, usually benign, mesenchymal neoplasms typically located in the cutaneous tissues of the extremities. Visceral locations have been reported in ∼5% of cases. The average age at diagnosis is 42 years. GTs originating in the respiratory tract of pediatric patients are exceedingly rare. We report a 16-year-old male with a GT of the right lower lobe bronchus.
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Affiliation(s)
- Moshe Y Prero
- Department of Pediatric Pulmonology, Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | - Melissa Gener
- Department of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, Missouri
| | - Eugenio M Taboada
- Department of Pathology and Laboratory Medicine, Children's Mercy Kansas City, Kansas City, Missouri
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Romanos E, Al Delfi F, Hubballah M, Farah C. Glomus tumour of the fourth toe: case discussion and review of literature. BMJ Case Rep 2019; 12:12/11/e231100. [PMID: 31772128 DOI: 10.1136/bcr-2019-231100] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
This is a case report with literature review and discussion of current diagnostic studies and management of a rare case of glomus tumour in the fourth toe of a 36-year-old male patient.
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Affiliation(s)
- Elie Romanos
- Orthopedic Surgery, Dr Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | - Firas Al Delfi
- Laboratory and Pathology, Dr Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | - Malek Hubballah
- Neurology and Neurosurgery, Dr Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
| | - Carl Farah
- Radiology, Dr Sulaiman Al Habib Hospital, Dubai, United Arab Emirates
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Thanindratarn P, Chobpenthai T, Phorkhar T, Nelson SD. Glomus tumor of uncertain malignant potential of the brachial plexus: A case report. World J Clin Cases 2019; 7:2815-2822. [PMID: 31616697 PMCID: PMC6789403 DOI: 10.12998/wjcc.v7.i18.2815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 06/25/2019] [Accepted: 07/20/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusual features can be occasionally found, leading to distinctive malignant potential required different therapeutic approaches. Glomus tumor of uncertain malignant potential is one type of atypical glomus tumor with limited criteria for malignancy and without metastasis.
CASE SUMMARY Herein, we report a case of a 48-year-old Thai male with a large painful mass in his axilla for one year without apparent neurological deficit. Magnetic resonance imaging showed a large heterogeneous mass encasing entire posterior cord of left brachial plexus and axillary artery. The tumor tissue from core needle biopsy histologically demonstrated the sheets and cords of relatively uniform tumor cells with foamy cytoplasm and round to oval hyperchromatic nuclei without atypia. The mitotic count was 0 per 50 high power field. A final diagnosis of glomus tumor of uncertain malignant potential was rendered. Complete surgical resection was performed, followed by adjuvant radiation due to positive margin. Neither local recurrence nor distant metastasis was observed at 2-year follow up. Unfortunately, postoperative incomplete brachial plexopathy without signs of re-innervation by electromyography was persisted. Later nerve grafting reconstruction was performed, followed by ongoing neurological rehabilitation.
CONCLUSION Glomus tumor of uncertain malignant potential is exceedingly rare, especially around brachial plexus. Although the prognosis is good, careful histological diagnosis and treatment are needed to achieve an optimal outcome with lower morbidity.
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Affiliation(s)
- Pichaya Thanindratarn
- Department of Orthopedic Surgery, Chulabhorn hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Lak Si, Bangkok 10210, Thailand
- Department of Orthopedic Surgery, Sarcoma Biology Laboratory, David Geffen School of Medicine, University of California, Los Angeles, CA 90024, United States
| | - Thanapon Chobpenthai
- Department of Orthopedic Surgery, Chulabhorn hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Lak Si, Bangkok 10210, Thailand
| | - Termphong Phorkhar
- Department of Orthopedic Surgery, Chulabhorn hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Lak Si, Bangkok 10210, Thailand
| | - Scott D Nelson
- Department of Pathology, University of California, Los Angeles, CA 90404, United States
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El Jouari O, Gallouj S, Elloudi S, Senhaji G, Rimani M, Mernissi FZ. A painless glomus tumor: a case report. J Med Case Rep 2018; 12:302. [PMID: 30333057 PMCID: PMC6193307 DOI: 10.1186/s13256-018-1837-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 09/06/2018] [Indexed: 01/16/2023] Open
Abstract
Background Glomus tumor is a benign and vascular hamartoma that originates from the neuromyoarterial cells of the normal glomus apparatus in the reticular dermis. The etiology of glomus tumors is unknown. It usually presents as a small, slightly raised, bluish or pinkish-red, painful nodule of the fingertips and the pulp. we report an atypical case of a patient of painless glomus tumor. Case presentation Our patient, a 60-year-old Moroccan man, had a 2.5 cm purplish painless soft tumor, covered with melliciric and hemorrhagic crusts, involving the first phalanx of his right index finger. This tumor was compressing his nail plate. No bony lesions were identified by radiographic studies, but magnetic resonance imaging was suggestive of glomus tumor. Surgical excision was performed with directed healing. Conclusions The diagnosis of a glomus tumor is an eventuality even in the absence of pain.
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Affiliation(s)
- Ouiame El Jouari
- Department of Dermatology University Hospital Hassan II, Fez, Morocco.
| | | | - Sara Elloudi
- Department of Dermatology University Hospital Hassan II, Fez, Morocco
| | - Ghita Senhaji
- Department of Dermatology University Hospital Hassan II, Fez, Morocco
| | - Mouna Rimani
- Hassan Center of Anatomopathology, Rabat, Morocco
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Zou H, Song L, Jia M, Wang L, Sun Y. Glomus tumor in the floor of the mouth: a case report and review of the literature. World J Surg Oncol 2018; 16:201. [PMID: 30305096 PMCID: PMC6180582 DOI: 10.1186/s12957-018-1503-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 09/28/2018] [Indexed: 12/25/2022] Open
Abstract
Background Glomus tumors are rare benign neoplasms that usually occur in the upper and lower extremities. Oral cavity involvement is exceptionally rare, with only a few cases reported to date. Case presentation A 24-year-old woman with complaints of swelling in the left floor of her mouth for 6 months was referred to our institution. Her swallowing function was slightly affected; however, she did not have pain or tongue paralysis. Enhanced computed tomography revealed a 2.8 × 1.8 × 2.1 cm-sized well-defined, solid, heterogeneous nodule above the mylohyoid muscle. The mandible appeared to be uninvolved. The patient underwent surgery via an intraoral approach; histopathological examination revealed a glomus tumor. The patient has had no evidence of recurrence over 4 years of follow-up. Conclusions Glomus tumors should be considered when patients present with painless nodules in the floor of the mouth.
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Affiliation(s)
- Haixiao Zou
- Department of Stomatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China.,State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Song
- Department of Stomatology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mengqi Jia
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China.,Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, No. 237 Luoyu Street, Wuhan, 430079, Hubei, China
| | - Li Wang
- Department of Pathology, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yanfang Sun
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China. .,Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, No. 237 Luoyu Street, Wuhan, 430079, Hubei, China.
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Cutaneous malignant glomus tumours: applicability of currently established malignancy criteria for tumours occurring in the skin. Pathology 2018; 50:711-717. [PMID: 30314644 DOI: 10.1016/j.pathol.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/11/2018] [Accepted: 08/17/2018] [Indexed: 11/21/2022]
Abstract
Glomus tumours (GTs) have traditionally been classified into benign GTs, GTs with uncertain malignant potential and malignant GTs, based on a combination of criteria such as size of the tumour, degree of nuclear atypia and the level of mitotic activity. Several of the proposed grading criteria are difficult, or even impossible to apply for GTs occurring in the skin. The aim of the study was to analyse the applicability of the currently established GT malignancy criteria for tumours occurring in the skin and to establish their prognostic significance. A total of 25 benign cutaneous GTs, 11 new cutaneous malignant GTs and 36 cutaneous malignant GTs previously published in the literature were studied. We analysed the following clinicopathological features and correlated them with disease outcome: age, sex, site, size, depth of invasion, degree of nuclear atypia, mitotic activity, growth pattern, vascular invasion, spindle-cell morphology and tumoural necrosis. Of all the clinicopathological parameters analysed, only tumoural necrosis was found by univariate analysis (p = 0.001) to be associated with adverse biological behaviour, and none by multivariate analysis. Multivariate statistical analysis failed to detect any clinicopathological features predictive of the disease outcome (e.g., local recurrence, development of metastatic spread and/or death of disease) in cutaneous malignant GTs. Furthermore, the currently established malignancy criteria for cutaneous GTs can be difficult to apply, mainly due to their smaller size. Likewise, counting mitotic activity per 50 high power fields can often not be accomplished in GTs occurring at superficial locations. Complete excision of these tumours coupled with long-term follow-up is the mainstay of treatment for cutaneous malignant GTs. The results of our study also suggest that cutaneous malignant GTs follow a more indolent clinical course than their deep soft tissue counterparts.
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