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Wu RC, Gao YH, Sun WW, Zhang XY, Zhang SP. Glomangiomatosis - immunohistochemical study: A case report. World J Clin Cases 2022; 10:5406-5413. [PMID: 35812671 PMCID: PMC9210917 DOI: 10.12998/wjcc.v10.i16.5406] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/05/2022] [Accepted: 04/04/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Glomangiomatosis (also known as diffuse glomus tumor) is extremely rare, accounting for only 5% of glomus tumors. The prevalence of glomus tumors is only 2% of soft tissue tumors. Lesions can recur after resection. Although growth may be diffuse or infiltrating and invasive, definitive identifying standards for malignant glomus tumors are lacking. This article describes a case of glomangiomatosis with many nodular masses in the soft tissues of the right foot and calf. A review of the Chinese and English-language literature is included.
CASE SUMMARY A case of glomangiomatosis in a 55-year-old Chinese woman who presented clinically with many nodular masses in the soft tissues of the right foot and calf. The tumor was examined histologically and immunostaining was performed.
CONCLUSION Glomangiomatosis occurs most often in young people, in the distal extremities, but is rare. Multiple nodules are even rarer. Only 15 clinicopathological analyses of glomangiomatosis have been reported in the combined Chinese- and English-language literature. In the present case, microscopically, nested vascular globular cells were observed around the blood vessel wall. Immunohistochemistry revealed diffuse immunoreactivity for smooth muscle actin, vimentin, type IV collagen, and Bcl-2. Caldesmon, CD34, and calponin were weakly, partially, and slightly positive, respectively. There was no recurrence 1 year after resection.
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Affiliation(s)
- Ruo-Chen Wu
- Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, Shandong Province, China
| | - Ying-Hua Gao
- Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, Shandong Province, China
| | - Wen-Wen Sun
- Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, Shandong Province, China
| | - Xiang-Yun Zhang
- Department of Pathology, The First People’s Hospital of Jining City, Jining 272000, Shandong Province, China
| | - Shu-Peng Zhang
- Department of Pathology, The Second Affiliated Hospital of Shandong First Medical University, Taian 271000, Shandong Province, China
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Boukas A, Aizpurua M, Maratos E, Kalyal N, Giamouriadis A, Barkas K, King A, Bodi I, Thomas N. A novel case of paravertebral glomangiomyomatosis. Br J Neurosurg 2022:1-6. [PMID: 35379054 DOI: 10.1080/02688697.2022.2054945] [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: 11/15/2021] [Revised: 02/25/2022] [Accepted: 03/13/2022] [Indexed: 11/02/2022]
Abstract
Glomangiomyomatosis is an extremely rare variant of glomus tumours. We describe the first known case of paravertebral glomangiomyomatosis in the literature to cause spinal cord compression. A 45-year old female patient presented with sudden onset of left leg pain and progressive weakness in left-sided hip flexion. An MRI spine revealed a large, lobulated, heterogeneous mass cantered on the left L2/3 foramen, mimicking a dumbbell nerve sheath tumour. The mass was invading the psoas muscle and displayed evidence of recent haemorrhage. The patient underwent debulking of the lesion via a left retroperitoneal approach. Surgery was uneventful, with clinical improvement and resolution of leg pain post-operatively. Histopathology of the tumour revealed delineated glomus-like cells and foci of spindled shaped cells resembling myoid differentiation. Immuno-histochemical features of the tumour confirmed the diagnosis of glomangiomyomatosis. The patient continued under close follow up, representing 18 months later with clinical and radiological progression of the disease with similar symptoms of leg pain but no weakness. Follow up MRI revealed progression of the intraspinal and paraspinal components of the tumour with thecal compression. A posterior approach was utilized in order to decompress the intraspinal component, which again was uneventful, and improved the patient's symptoms. This is the first known case of paravertebral glomangiomyomatosis in the literature and this rare entity should be considered in the differential diagnosis of nerve sheath tumours due to risk of progression and recurrence.
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Affiliation(s)
| | - Miren Aizpurua
- Department of Neuropathology, King's College Hospital, London, UK
| | - Eleni Maratos
- Department of Neurosurgery, King's College Hospital, London, UK
| | - Nida Kalyal
- Department of Neurosurgery, King's College Hospital, London, UK
| | | | | | - Andrew King
- Department of Neuropathology, King's College Hospital, London, UK
| | - Istvan Bodi
- Department of Neuropathology, King's College Hospital, London, UK
| | - Nicholas Thomas
- Department of Neurosurgery, King's College Hospital, London, UK
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Glynn D, Hynes J, Richards K, O'Toole G, O'Keane C, Kavanagh E. Glomangiomatosis of the lower leg. Radiol Case Rep 2022; 17:963-966. [PMID: 35106104 PMCID: PMC8784297 DOI: 10.1016/j.radcr.2022.01.008] [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: 12/13/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 11/17/2022] Open
Abstract
This paper demonstrates a case of multiple glomangiomas, or glomangiomatosis, including clinical presentation, imaging appearances, and subsequent management. Differentiating features from typical glomus tumors are described. To the best of our knowledge, this is the first reported case of a glomangioma involving the distal tibiofibular syndesmosis.
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Affiliation(s)
- David Glynn
- Department of Radiology, National Orthopaedic Hopsital Cappagh, Dublin, Ireland
- Corresponding author. D. Glynn. Cappagh National Orthopaedic Hospital, Cappagh Road, Cappoge, Dublin 11, D11 EV29
| | - John Hynes
- Department of Radiology, National Orthopaedic Hopsital Cappagh, Dublin, Ireland
| | - Kate Richards
- Department of Pathology, Mater Misercordiae University Hospital, Dublin, Ireland
| | - Gary O'Toole
- Department of Orthopaedic Surgery, National Orthopaedic Hopsital Cappagh, Dublin, Ireland
| | - Conor O'Keane
- Department of Pathology, Mater Misercordiae University Hospital, Dublin, Ireland
| | - Eoin Kavanagh
- Department of Radiology, National Orthopaedic Hopsital Cappagh, Dublin, Ireland
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Liao Z, Chen C, Wang B, Yang C. Minimally invasive resection of a glomus tumor of the thoracic spine: a case report and literature review. J Int Med Res 2019; 47:2746-2753. [PMID: 31079513 PMCID: PMC6567690 DOI: 10.1177/0300060519847340] [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: 11/16/2022] Open
Abstract
Objective Spinal involvement of glomus tumors is extremely rare. We herein present a case of a spinal glomus tumor and reviewed the literature to identify the most effective surgical treatment of spinal glomus tumors. Methods A 48-year-old man presented with a huge paravertebral space-occupying lesion. In this report, we present the diagnostic process and surgical procedure in this case and review the literature of glomus tumors with spine involvement. Results We suspected a primary diagnosis of neurilemmoma based on the imaging results; however, the postoperative pathologic examination confirmed a glomus tumor. Considering the size of the tumor and involvement of surrounding areas, we performed complete tumor resection and unilateral fusion with pedicle screws at the T2 to T4 level. This unilateral approach with fixation was less invasive than the standard open posterior approaches that are used when one side of the spinal canal is intact without bony destruction. Conclusions Surgical resection is a suitable treatment for most symptomatic glomus tumors. For most glomus tumors with spine involvement, total tumor resection with suitable internal fixation and fusion is recommended.
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Affiliation(s)
- Zhiwei Liao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chao Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bingjin Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Cao Yang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Fitzhugh VA, Beebe KS, Wenokor C, Blacksin M. Glomangiomatosis: a case report. Skeletal Radiol 2017; 46:1427-1433. [PMID: 28656356 DOI: 10.1007/s00256-017-2697-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 05/31/2017] [Accepted: 06/07/2017] [Indexed: 02/02/2023]
Abstract
Glomangiomatosis is a benign vascular variant of a glomus tumor. The lesion represents only 5% of glomus tumors with unusual or atypical features and even fewer glomus tumors with typical features. The lesions are most commonly located in the distal extremities and are multiple, deep, extensive, and often pain producing. They develop from small arteriovenous anastamoses and are most often identified in young adults. The lesions may recur. We present a case of a 33-year-old male who presented clinically with multiple slowly enlarging masses of the leg over a 5-year period, of which one caused significant pain. One of the lesions was reported to be present at birth. Imaging studies were performed and were suggestive of neurofibromatosis. Biopsies from multiple lesions led to an eventual diagnosis of multiple glomangiomatosis.
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Affiliation(s)
- Valerie A Fitzhugh
- Department of Pathology and Laboratory Medicine, Rutgers, the State University of New Jersey-New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, 07103, USA.
| | - Kathleen S Beebe
- Department of Orthopaedics, Rutgers, the State University of New Jersey-New Jersey Medical School, Newark, NJ, USA
| | - Cornelia Wenokor
- Department of Radiology, Rutgers, the State University of New Jersey-New Jersey Medical School, Newark, NJ, USA
| | - Marcia Blacksin
- Department of Radiology, Rutgers, the State University of New Jersey-New Jersey Medical School, Newark, NJ, USA
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A Case of Glomangiomatosis of the Ankle and Foot: Ultrasonographic Appearance Correlated With the Magnetic Resonance Imaging Findings. Ultrasound Q 2015; 32:180-2. [PMID: 25831152 DOI: 10.1097/ruq.0000000000000153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Glomangiomatosis, a rare category of glomus tumors, comprises 2% to 3% of glomus tumors in adults. We report a case of glomangiomatosis in a 48-year-old man who underwent multiple excisions of recurrent soft tissue masses in the ankle and foot. Ultrasonography revealed multiple nodular soft tissue tumors and dilated vascular channels with increased blood flow, suggesting the presence of vascular tumors. Here, we discuss the ultrasonography imaging features of glomangiomatosis, which have not been previously reported, correlate them with magnetic resonance imaging findings, and provide a brief review of the literature.
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Sano K, Hosaka K, Ozeki S. Glomangiomatosis concentrated in the ankle with varied appearances: a case report. J Foot Ankle Surg 2014; 53:468-71. [PMID: 24726795 DOI: 10.1053/j.jfas.2014.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Indexed: 02/03/2023]
Abstract
Glomangiomatosis is an exceedingly rare condition. This report details a case of multiple glomangiomas concentrated in the ankle of a 59-year-old male. Despite identical histological findings, the lesions displayed varied clinical features at physical examination, at magnetic resonance imaging, and upon further examination after excision. Unlike solitary glomus tumors, glomangiomas can vary widely in clinical appearance.
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Affiliation(s)
- Kazufumi Sano
- Department of Orthopaedic Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan.
| | - Koji Hosaka
- Department of Orthopaedic Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
| | - Satoru Ozeki
- Department of Orthopaedic Surgery, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama, Japan
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Abstract
Glomus tumors are rare benign neoplasms usually arising from soft tissues. Surgical removal seems to be the best treatment. Here, we report the case of a 52-year-old female patient referred for chronicback pain, revealing a thoracic paravertebral tumor with no osseous extension. After surgical removal,this tumor turned out to be a glomangioma. Differential diagnosis with other more frequent tumors,such as schwannoma, is particularly difficult. A review of the relevant literature will be presented. A better knowledge of the natural history of those tumors, as well as the therapeutic options available, are necessary for spinal surgeons who may encounter such presentations.
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Freire M, Rubin B, Lietman S, Sundaram M. Solitary glomus tumor recurring as multiple glomus tumors. Skeletal Radiol 2012; 41:1333-7. [PMID: 22733358 DOI: 10.1007/s00256-012-1410-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 03/26/2012] [Accepted: 03/29/2012] [Indexed: 02/02/2023]
Abstract
Most glomus tumors arise as a single nodule. However, up to 10 % of glomus tumors may be multiple. We report a case in which a single glomus tumor of the leg that evolved several years after surgery to multiple glomus tumors requiring additional resections.
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Affiliation(s)
- Maxime Freire
- Department of Radiology, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216, USA.
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