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Acharya S, Anwar S, Thapa K, Thapa S, Lau M. Pulmonary Glomus Tumor. Cureus 2023; 15:e38684. [PMID: 37292573 PMCID: PMC10246930 DOI: 10.7759/cureus.38684] [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: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
Glomus tumors, which account for less than 2% of soft tissue tumors, are a rare benign soft tissue neoplasm. They originated from neuro-myo-arterial glomus tissue whose primary function is regulation of the body temperature. This tissue is commonly located in the dermis or subcutis in the subungual region; however, it can be extracutaneous such as in bones, the genitourinary tract, the gastrointestinal tract, and the respiratory tract. Histologically, a glomus tumor is made of proliferating rounded or cuboidal epithelioid cells in a meshwork of blood vessels. Although a benign growth, they can rarely show malignant features with infiltration of surrounding tissue with the rapid multiplication of cells in which case it is labeled as a malignant glomus tumor. Pulmonary glomus tumors are extremely rare and most commonly occur in middle-aged men. They are mostly asymptomatic, but a small percentage of patients may present with hemoptysis and cough if there is large airway involvement. We present an interesting case of a middle-aged man presenting with cough and occasional hemoptysis, found to have an endobronchial nodular lesion, and subsequently diagnosed with a pulmonary glomus tumor.
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Affiliation(s)
- Sudeep Acharya
- Pulmonary and Critical Care Medicine, Staten Island University Hospital, Staten Island, USA
| | | | - Kumar Thapa
- Internal Medicine, Staten Island University Hospital, Staten Island, USA
| | - Sakura Thapa
- Internal Medicine, Green City Hospital, Kathmandu, NPL
| | - Michael Lau
- Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, USA
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Deng M, Luo R, Huang J, Luo Y, Song Q, Liang H, Xu C, Yuan W, Hou Y. Clinicopathologic features of gastric glomus tumor: A report of 15 cases and literature review. Pathol Oncol Res 2023; 28:1610824. [PMID: 36699621 PMCID: PMC9868133 DOI: 10.3389/pore.2022.1610824] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023]
Abstract
Objective: Glomus tumor is a relatively uncommon soft tissue neoplasm predominantly occurring in upper extremity (fingers), less reported in stomach. This study aimed to discuss the clinicopathologic features of gastric glomus tumor (GGT) and then provide reference for clinical practice. Methods: A retrospective analysis of all cases pathologically diagnosed of GGT was performed, pathological findings were correlated with clinical information, immunohistochemical studies, next-generation sequencing, and patient follow-ups. A review of literature by searching similar cases was conducted to summarize previous knowledge of GGTs. Results: Our study identified 15 GGTs included 5 males and 10 females, aged between 35-75 years old (median, 49 years old). The tumor was located to the gastric corpus in 6 cases (40%) and to the antrum in 9 cases (60%). The maximum tumor diameter ranged between 1-4 cm (median, 1.5 cm). There were 11 cases (73%) of solid glomus tumor, 3 cases (20%) of mixture of solid glomus tumor and glomangioma, and 1 case (7%) of glomangiomyoma. Partial spindle cell area was observed in 3 cases (20%), moderate cellular atypia in 1 case (7%), atypical mitosis in 1 case (7%), vascular invasion in 5 cases (33%), neural invasion in 6 cases (40%) and tumor necrosis in 1 case (7%). Tumor cells expressed Collagen type IV, α-smooth muscle actin (α-SMA), and synaptophysin in most cases. The Ki67 index varied from 1% to 30%. Next-generation sequencing reported EGFR, PIK3CA, KEAP1 and TP53 mutation. The outcome information was obtained in 12 (80%) cases, followed for 6-63 months, 11 patients (92%) had tumor-free survival and 1 patient (8%) developed liver metastasis 26 months after surgery. Literature review obtained 16 previously reported malignant GGT cases. In terms of the total 31 cases, univariate analysis revealed that the atypical mitosis (OS: p = 0.009; DFS: p = 0.010) and severe cellular atypia (OS: p = 0.007; DFS: p = 0.004) were significantly associated with poor prognosis (patient death). Conclusion: GGT is indolent, while long-term close follow-up should be required in the presence of increasing number of risk factors. Malignant GGT is relatively uncommon and predisposes to liver metastasis, calling for accumulation of large-sample data and experience.
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Affiliation(s)
- Minying Deng
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Rongkui Luo
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jie Huang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuanlong Luo
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qi Song
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Huaiyu Liang
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chen Xu
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Wei Yuan
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, 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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Obata T, Miyazaki T, Yamasaki N, Tsuchiya T, Matsumoto K, Hatachi G, Kitamura Y, Tabata K, Nagayasu T. Successful Resection of locally infiltrative Glomus Tumor without pulmonary resection. Int J Surg Case Rep 2017; 41:191-193. [PMID: 29096341 PMCID: PMC5683888 DOI: 10.1016/j.ijscr.2017.09.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 09/08/2017] [Indexed: 12/29/2022] Open
Abstract
Extracutaneous glomus tumors occurring in the bronchus is very rare. Two term resections enabled us to make an accurate diagnosis and evaluation. After bronchoscopic treatment, curative pulmonary resection was performed and preservation of lung function was successful.
Introduction Extracutaneous glomus tumors occurring in the bronchus is very rare. Complete resection is basic procedure for treatment of glomus tumor. We present a glomus tumor of the left main bronchus that was successfully treated with rigid bronchoscopy followed by sleeve resection of the left main bronchus. Presentation of case A 56-year-old man underwent two term resections to glomus tumor that originated from the left main bronchus. Firstly, we performed palliative resection with rigid bronchoscopy to make the correct diagnosis and evaluate the extent of the tumor. We subsequently performed curative resection. No complications or recurrence has occurred since the operation took place one year ago. Discussion Before curative resection, it is important to confirm the diagnosis and spread of the tumor. Therefore, palliative tumor resection by rigid bronchoscopy was useful to make the correct diagnosis, evaluate the extent of the tumor and open the bronchial lumen. After bronchoscopic treatment, curative pulmonary resection was performed and preservation of lung function was successful. Conclusion Two term resections enabled us to make an accurate diagnosis and evaluation, thereby preserving respiratory function without pulmonary resection.
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Affiliation(s)
- Tomohiro Obata
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Takuro Miyazaki
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Naoya Yamasaki
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Tomoshi Tsuchiya
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Keitaro Matsumoto
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Go Hatachi
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Yuka Kitamura
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Kazuhiro Tabata
- Pathology, and Division of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Japan.
| | - Takeshi Nagayasu
- Departments of Surgery, Nagasaki University Graduate School of Biological Sciences, Japan.
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Krishnakumar M, Sharma R, Pawar HS, Hasnain S. Anaesthetic management of left main bronchial glomus tumour. Indian J Anaesth 2016; 60:276-9. [PMID: 27141112 PMCID: PMC4840809 DOI: 10.4103/0019-5049.179466] [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] [Indexed: 11/04/2022] Open
Abstract
Glomus tumours involving bronchus are rare. Surgical resection is the treatment of choice for this tumour, with excellent prognosis. The nature and location of tumour pose a significant challenge for perioperative anaesthetic management. However, there is a paucity of case reports on anaesthetic risks involved in case of a bronchial glomus tumour. We present a case of glomus tumour involving left main stem bronchus, subjected to bronchial sleeve resection. The various anaesthetic implications of this tumour type and airway management with right double lumen tube are discussed.
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Affiliation(s)
- Mathangi Krishnakumar
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Rammurti Sharma
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Harshwardhan Singh Pawar
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
| | - Shahbaz Hasnain
- Department of Anaesthesiology and Critical Care, Armed Forces Medical College, Pune, Maharashtra, India
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Wan PZ, Han Q, Wang EH, Lin XY. Glomus tumor of uncertain malignant potential of the lung: a case report and review of literature. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:15402-15406. [PMID: 26823902 PMCID: PMC4713688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/21/2015] [Indexed: 06/05/2023]
Abstract
Glomus tumor is an uncommon tumor usually presenting in the dermis. Rarely, it occurred in visceral organs including stomach, liver and long. The majority of glomus tumors were benign. Herein, we present a case of glomus tumor located in the left lobe of the lung in a 49 year-old Chinese male. An irregular mass measuring 3 cm was detected by imaging examination because of his suffering from cough, dyspnea and chest pain. Histologically, the tumor is composed predominantly of sheets of ovoid to round cells with clear border, pale cytoplasm and fine granular chromatin. The mitotic count was less than 5 per 50 HPF. The tumor focally invaded the surrounding normal bronchial and alveolar tissue. Immunohistochemical staining showed that the cells were diffusely positive for SMA, caldesmon, and vimentin. The Ki-67 proliferation index was approximately 20%. Based on morphologic features and the immunohistochemical profile, the tumor was consistent with glomus tumor of uncertain malignant potential.
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Affiliation(s)
- Peng-Zhi Wan
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University Shenyang 110001, China
| | - Qiang Han
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University Shenyang 110001, China
| | - En-Hua Wang
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University Shenyang 110001, China
| | - Xu-Yong Lin
- Department of Pathology, The First Affiliated Hospital and College of Basic Medical Sciences, China Medical University Shenyang 110001, China
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Fernandez-Bussy S, Labarca G, Rodriguez M, Mehta HJ, Jantz M. Concomitant tracheal and subcutaneous glomus tumor: Case report and review of the literature. Respir Med Case Rep 2015; 16:81-5. [PMID: 26744663 PMCID: PMC4681967 DOI: 10.1016/j.rmcr.2015.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 08/06/2015] [Indexed: 11/13/2022] Open
Abstract
Glomus tumors are unusual and generally benign neoplasms mainly found in subungeal areas. We describe a case of concomitant subcutaneous and tracheal glomus tumor that underwent successful endoscopic resection. A 48-year old male with a left forearm subcutaneous mass presented with hemoptysis. A chest CT scan demonstrated a polypoid tracheal lesion. He underwent a bronchoscopic resection. A biopsy revealed a glomus tumor, which was the same type of neoplasm that was found on the forearm biopsy. Glomus tumors are rarely found in the respiratory tract. Only 49 cases have been described. The majority of the glomus tumors arise from the lower posterior tracheal wall with no extraluminal extension. Bronchoscopic resection has been successfully used. Glomus tumors should be included in the differential diagnosis of tracheobronchial lesions. Bronchoscopic resection and adjuvant radiotherapy are valid treatment options. This is the first report of concomitant subcutaneous and tracheal glomus tumor, as well as the first reported airway glomus tumor, in Latin America. As part of this study, we also perform a literature review.
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Affiliation(s)
| | - Gonzalo Labarca
- Resident of Internal Medicine Interna, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Macarena Rodriguez
- Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hiren J Mehta
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Florida, USA
| | - Michael Jantz
- Division of Pulmonary, Critical Care, and Sleep Medicine, University of Florida, Florida, USA
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A malignant glomus tumor in the upper trachea. Ann Thorac Surg 2015; 99:1812-4. [PMID: 25952217 DOI: 10.1016/j.athoracsur.2014.05.102] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 05/10/2014] [Accepted: 05/27/2014] [Indexed: 11/20/2022]
Abstract
Malignant glomus tumors are extremely rare, and a malignant glomus tumor in the trachea has not been described previously. In this report, we present the first known case of a malignant glomus tumor originating in the trachea.
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Lin F, Yang M, Pu Q, Ma L, Liu C, Mei J, Guo C, Liu L. Malignant glomus tumor in pleural cavity. J Thorac Dis 2015; 7:E126-30. [PMID: 26101658 DOI: 10.3978/j.issn.2072-1439.2015.04.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 04/10/2015] [Indexed: 02/05/2023]
Abstract
Glomus tumors, an uncommon hypervascular tumor, arise from modified smooth muscle cells of the glomus body that plays a significant role in the regulation of skin circulation. The tumors are usually located in the extremities, typically in the subungual region of the fingers. Primary glomus tumors of the chest are extremely rare, and to our knowledge, there are no cases have been described in thoracic cavity to date. We here report a case of intrathoracic glomus tumor in a 31-year-old man who presented with a persistent chest pain. Chest computed tomography scans demonstrated an irregularly shaped mass in the left thorax. Left thoracotomy was performed under the suspicious diagnosis of unexplained thorax tumor, and a tumor located in the left upper portion of thorax was founded. Complete resection of tumor along with the partial structure of chest wall was performed. Postoperative diagnosis was malignant glomus tumor.
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Affiliation(s)
- Feng Lin
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Mei Yang
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Qiang Pu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Lin Ma
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Chengwu Liu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Jiandong Mei
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Chenglin Guo
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
| | - Lunxu Liu
- 1 Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China ; 2 Department of Thoracic Surgery, Affiliated Hospital of Guiyang Medical College, Guiyang 550004, China
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