Glomus Tumor of the Sciatic Nerve: An Extraspinal Cause of Sciatica

Posterior Cervical Glomus Tumor Mimicking Neurogenic Occipital Pain

Glomus tumors, typically localized in digits, palms, and soles, rarely occur in the posterior cervical region. This case report describes a unique presentation of an epithelioid glomus tumor in a 49-year-old male with a history of progressive occipital headaches. A 49-year-old male, referred with a five-year history of worsening occipital headaches, presented a palpable lesion in the right suboccipital area. MRI identified a 2.3 cm subcutaneous lesion adjacent to the right occipital artery, raising initial suspicion of a schwannoma. Subsequent excisional biopsy unveiled an unexpected diagnosis - an epithelioid glomus tumor. The rarity of glomus tumors in the posterior cervical region, coupled with their potential to mimic neurogenic tumors like schwannomas, underscores the diagnostic complexity. This encounter of a glomus tumor in an uncommon posterior cervical location serves as a pertinent reminder for neurosurgeons to consider atypical differentials. This case underscores the need for heightened clinical vigilance when faced with unusual presentations in neurosurgical practice.

Post-traumatic glomus tumor of the left anterior supraclavicular nerve: a case report

OBJECTIVES

Peripheral nerve glomus tumors are extremely rare and occur with typical symptoms of peripheral neuropathic pain. Clinicians hardly consider this entity when faced with the swelling of a peripheral nerve and the diagnosis is reached only with histological examination. Nerves of limbs are usually affected and the solid glomus tumor is the most frequent histological variant.

CASE DESCRIPTION

A 55-year-old man presented with a glomus tumor of the anterior supraclavicular nerve of the left cervical plexus, misdiagnosed clinically and radiologically as neuroma. Despite the preoperative suspicion and the intraoperative appearance, the histological examination revealed a glomus tumor with a prevalent muscular component, a glomangiomyoma. Once the tumor was removed, pain regressed completely.

CONCLUSIONS

Because of its rarity, pre-operative diagnosis of glomus tumors is still a challenge, especially when arising from peripheral nerves. In the presence of chronic localized neuroma-type pain and sensitivity, glomus tumors should be considered in the pool of differential diagnosis, even if the imaging is not conclusive.

Glomus Tumors of the Distal Phalanx: A Retrospective Review of Clinical Diagnosis and Treatment

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.].

Unusual glomus tumor of the bladder: a rare case report and literature review

Background

Glomus tumor (GT), which are neoplasms of the glomus body, usually occur in the extremities, particularly under the nail bed. GT occurring in the bladder is very rare and has been reported as sporadic. In the present study, a rare case of bladder GT is reported and its clinical and histopathological characteristics are summarized by literature review.

Case presentation

A 57-year-old woman presented with intermittent gross hematuria for 2 years. Urinalysis displayed hematuria. The bladder ultrasound showed an avascular and homogeneous isoechoic polypoid mass with a maximum diameter of 6 mm at the right lateral wall of bladder. The bladder endoscopic examination showed a polypoid lesion, with a smooth surface, located in the right lateral wall. Then, a transurethral resection was performed, its histopathological features indicated a benign GT.

Conclusions

GT arising in the bladder is extremely rare, and only four cases have been identified in studies reported in English. It is difficult to diagnose bladder GTs according to their clinical features. The gold standard method used for their diagnosis is histopathology. However, it should also be considered in the differential diagnosis for bladder mass.

Unilateral lower limb atrophy associated with glomus tumors: a case report

Background

Glomus tumors are soft tissue neoplasms comprised of glomus cells, vasculature, and smooth muscle cells, which occur commonly in a single subungual area of the digits, and their main clinical features include severe paroxysmal pain, localized tenderness, and cold hypersensitivity.

Case presentation

A 47-year-old Japanese man had suffered from chronic progressive paroxysmal shooting pain in his right leg since childhood. He avoided putting weight on his right foot whenever he walked. The frequency of paroxysmal pain and the number of tender points both gradually increased with age, and his right leg gradually atrophied. Magnetic resonance imaging of the lower extremity demonstrated multiple gadolinium-enhanced nodules that corresponded with his tender points. Excisional biopsy relieved his pain and provided a histopathological diagnosis of glomus tumors.

Conclusion

This case suggests that small glomus tumors located in deep tissue may cause disuse atrophy because of their long delay before diagnosis. Clinicians should consider the potential for glomus tumors when patients exhibit unilateral lower limb muscular atrophy with pain.

Effectiveness comparisons of Chinese patent medicine on sciatica: A protocol for systematic review and Bayesian network meta-analysis

BACKGROUND

Sciatica is one of the common clinical diseases. Studies have proved the efficacy of Chinese patent medicine (CPM) in the treatment of sciatica, so far, there has not been a complete systematic review of its effectiveness and safety, and the comparative efficacy and safety of CPM have not been ranked. Therefore, it is necessary to evaluate the efficacy and safety of these CPM by means of systematic review and network meta-analysis (NMA), and to compare them in order.

METHODS

We will search PubMed, Cochrane Library, EMbase, Web of Science, CNKI, Wanfang, VIP, CBM and other databases for RCTs of CPM in the treatment of sciatica, (database established until December 30, 2020). In addition, we will manually search the "Pharmaceutical Information", "National Essential Drug List", "Chinese Pharmacopoeia", etc. to inquire about drug instructions, and screen the market circulation and clinically commonly used CPM. We will use RevMan software, gemtc package, GeMTC software for statistical analysis, and draw the surface under cumulative ranking area (SUCRA) to predict the order of curative effect of treatment measures.

RESULTS

Our study will compare and evaluate the effectiveness of CPM in the treatment of sciatica, and rank different CPM. The outcome indicators will include clinical efficacy, pain degree, lumbar spine function and adverse events.

CONCLUSION

Our research will provide support for clinical practice.

INPLASY REGISTRATION NUMBER

INPLASY2020110073.