Atypical glomus tumor arising in the liver: a case report

Rare Occurrence of Extradigital Glomangioma in the Prepatellar Bursa of a 40-Year-Old: A Case Study

Introduction

A solitary subcutaneous mass can be a common clinical finding for patients symptomatic for knee pain, especially when direct pressure by kneeling on the anterior aspect of the knee causes pain.

Case Report

We present a 40-year-old who noticed a small fluid filled mass that has become progressively larger and more painful over the past 7 years. The patient's primary complaint was sharp pain with direct contact. Ultimately, a surgical excision was performed to remove the mass. The histopathological report came back as a glomangioma, a subtype of a glomus tumor. To the best of our knowledge, this is the youngest reported case of a glomangioma of the knee.

Conclusion

Glomus tumors found on the digital and subungual regions of patients are a common clinical finding. An extradigital occurrence of a glomangioma, a subtype of a glomus tumor, is rarely found, especially in younger patients. Therefore, a histopathological examination must be done after the removal of any subcutaneous mass.

Surgical administration of multiple glomus tumors in uncommon anatomic regions in a 17-year-old female. A rare case report

Glomus tumor (GT) constitutes a rare, benign, soft-tissue tumor emerging from neuro-myo-arterial glomus bodies. Due to its rarity, and absence of typical symptoms, GT is usually misdiagnosed, with a potential risk of rupture and infection, or even malignant transformation. The present manuscript reports a rare case of a 17-year-old young woman with multiple GTs in her lower back, breach and left thigh that was surgically treated. The manuscript aims to highlight the importance of prompt diagnosis and surgical treatment of this peculiar tumor in young patients and raise surgeons’ awareness.

Mesenchymal tumours of the gastrointestinal tract

Mesenchymal tumours represent a heterogenous group of neoplasms encopassing benign, intermediate malignancy, and malignant entities. Sarcomas account for approximately 1% of human malignancies. In consideration of their rarity as well as of intrinsic complexity, diagnostic accuracy represents a major challenge. Traditionally, mesenchymal tumours are regarded as lesions the occurrence of which is mostly limited to somatic soft tissues. However, the occurrence of soft tissue tumours at visceral sites represent a well recognized event, and the GI-tract ranks among the most frequently involved visceral location. There exist entities such as gastrointestinal stromal tumours (GIST) and malignant gastointestinal neuroectodermal tumors that exhibit exquisite tropism for the GI-tract. This review will focus also on other relevant clinico-pathologic entities in which occurrence at visceral location is not at all negligible.

An unusual case of chest wall glomus tumor presenting with axillary pain: a case report and literature review

BACKGROUND

Glomus tumor is an uncommon soft tissue tumor. However, as the tumor causes significant disability, its early diagnosis is essential. It involves subungual areas of fingers and toes in most cases, and its extra-digital involvement is rarely seen. To the best of the authors' knowledge, only a few chest wall involvement cases have been reported in the literature.

CASE PRESENTATION

In this paper, we describe a 63-year-old patient with a chest wall glomus tumor presenting with axillary paroxysmal pain and limitation in his shoulder range of motion that had been missed for nearly 15 years. His symptoms were relieved immediately following surgical excision.

CONCLUSION

Glomus tumors may involve any part of the human body. It is curable with surgical excision in most cases. Therefore, a correct early diagnosis has paramount importance. A high index of suspicion is needed for early diagnosis, especially when the tumor involves uncommon anatomic areas.

The first malignant primary hepatic glomus tumor: A case report

•

This is the first malignant primary hepatic glomus tumor.

•

Glomus tumor diagnosis involves morphologic and immunohistochemical features.

•

Our glomus tumor had an inactivating TP53 mutation.

•

Consider glomus tumors when evaluating heterogeneous liver masses.

Introduction

Glomus tumors (GTs) are rare neoplasms that originate from the modified smooth muscle cells of glomus bodies and occasionally arise from visceral primary sites. All previously reported primary hepatic GTs were benign. Here we report the first malignant primary hepatic GT.

Presentation of case

Our patient is a 60-year-old male who presented with weight loss, early satiety, night sweats, and abdominal distention. Imaging demonstrated a large mass abutting the stomach, duodenum, and head of the pancreas, exerting mass effect on the portal vein and inferior vena cava. Biopsy results were deemed nondiagnostic after extensive review at multiple academic institutions. We performed a caudate lobe resection, antrectomy, and Bilroth II gastrojejunostomy that required skeletonization of much of the periportal vascular anatomy and the repair of multiple venotomies due to the tumor’s adherence to the inferior vena cava. Histopathologic evaluation revealed morphologic and immunohistochemical findings consistent with a malignant GT, and next-generation sequencing using a targeted panel revealed an inactivating TP53 mutation.

Discussion

This case presented both a surgical and histopathologic challenge, requiring meticulous operative technique for resection in conjunction with a combination of characteristic morphologic features and immunohistochemical staining for diagnosis. Sequencing results using a targeted panel add to the limited GT genomic literature.

Conclusion

While rare, it is important to consider malignant GTs in the differential diagnosis for heterogeneous liver masses. Close follow-up will be essential to monitor our patient’s clinical course and expeditiously pursue any further interventions.

Imaging of a glomus tumor of the liver in a child

Glomus tumors occur preferentially in the subcutaneous tissue of the fingers and toes, but are extremely rare in visceral organs. Although, there have been several reports of glomus tumors in the liver in adult patients, there have yet been no publications reporting glomus tumors of the liver in children. Here, we report a case of an 11-year-old girl who was admitted with a 2-week history of progressive dyspnea on exertion and vomiting. Upon physical examination, she was found to have hypertension and a palpated smooth, firm mass at the epigastrium. Abdominal MRI revealed a well-defined exophytic hypervascular mass with intratumoral hemorrhage at segment 3/4b of the liver. Ultrasound-guided biopsy revealed it to be a glomus tumor. An ultrasound conducted at a 1-month follow-up after preoperative embolization revealed that the mass had decreased in size. A subsequent exploratory laparotomy with left hepatectomy was performed and the histologic results confirmed the diagnosis.

Glomus Tumor of Sella Turcica With Synaptophysin Expression Mimicking Pituitary Adenoma

Glomus tumor can rarely arise in the central nervous system as a sella turcica mass. In this article, we report a case of sellar glomus tumor in a female patient who presented at the age of 8 years with visual impairment. The tumor recurred at 4 years and 26 years after initial excision and gamma knife therapy. Histologic examination showed a monotonous population of oval cells accompanied by delicate blood vessels, features mimicking pituitary adenoma. The tumor showed histologic progression at the second recurrence. Synaptophysin staining was positive, but chromogranin and CD56 were negative. The tumor cells were negative for epithelial markers but expressed actin and SMA. Awareness of the rare occurrence of glomus tumor at this region, careful analysis of morphology, and appropriate immunohistochemical workup are essential to solve this diagnostic challenge. The clinicopathologic features of all previously reported cases are reviewed.

Rare presentation of a testicular glomus tumour

Glomus tumours are atypical in extracutaneous locations and very rarely located in reproductive organs. We present an unusual case of an incidentally discovered glomus tumour arising from the testis of a 47-year-old man. The testicular occurrence of this tumour type is not only exceptionally rare but also serves to highlight the debate regarding the optimal management of incidentally discovered small testicular lesions.

Unusual location of the glomus tumour in the liver: A case report and literature review

RATIONALE

Liver glomus tumor is very rare, and only 6 cases have been reported. Herein, we report another case of liver glomus tumor and the clinicopathological features are summarized.

PATIENT CONCERNS

An 18-year-old male patient was admitted due to hypertension and arrhythmia for 4 days.

DIAGNOSES

Abdominal enhanced CT revealed a 6.0-cm solid and cystic mass in the left liver lobe. The mass was collected by hepatic lobectomy. Microscopically, the tumor cells were round or oval, and had no malignant features and no evident atypia. Immumohistochemically, tumor cells were positive for positive for SMA and vimentin, but partially positive for syn, CD34 and desmin. He was pathologically diagnosed with liver glomus tumor.

INTERVENTIONS

The patient underwent a left hepatic lobectomy.

OUTCOMES

After surgery, this patient was followed up for 6 months, and metastasis/recurrence was not observed.

LESSONS

Primary liver glomus tumor has no specific clinical manifestations, and imaging examinations have limitations for its diagnosis. Immunostaining for SMA and vimentin is necessary to prove the diagnosis. Complete resection is strongly advised and it has a favorable prognosis.

Glomus Tumor of the Scrotum: A Case Report and Mini-Review

Glomus tumor in the genital area is extremely rare, with an extensive search in the medical literature revealing only 1 case arising in the scrotum. They can be easily mistaken, both clinically and radiologically, for skin neoplasms or primary testicular tumors involving the scrotum. This report presents a case of a 54-year-old man who presented with a painful right scrotal swelling. Ultrasound suggested the possibility of an epidermal inclusion cyst. The excised mass was diagnosed as a benign glomus tumor. To the best of our knowledge, this is the second case of glomus tumor of the scrotum described in the literature. This report expands the differential diagnoses of scrotal neoplasms. Furthermore, essential guidelines necessary to distinguish glomus tumor from other lesions in the scrotum are discussed.

Unusual Glomus Tumor of the Penis

INTRODUCTION

Glomus tumors are benign neoplasms commonly found in subungual regions of the extremities and rarely located in the penis. Misdiagnosis of glomus tumors is common; therefore, symptoms and clinical presentations should be reviewed.

OBJECTIVE

The primary objective of this review article is to emphasize the pathogenesis, pathology, clinical presentation, symptoms, diagnosis, and treatment methods of glomus tumors in order to better identify and manage the condition.

MATERIALS AND METHODS

Research was conducted using PubMed/Medline. The inclusion criteria required glomus tumor to be present on the penis.

RESULTS

Glomus tumors, which appear as symptomatic or asymptomatic lesions, are attributed to dispersion grouping of neoplastic or non-neoplastic lesions in a particular area.

CONCLUSION

Differential diagnosis of glomus tumors includes hemangiomas, neurofibromatosis, epithelial lesions, and spindle-cell lesions. Physical examination and histological findings should be used for diagnosis. Treatment options can be either conservative or invasive, in which the patient undergoes surgical excision.

Glomus tumor of uncertain malignant potential of the lung: a case report and review of literature

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.