Diagnosis Of Glomus Tumor Research Articles

A case series of two glomus tumors of the gastrointestinal tract

Two recent cases of glomus tumors (GTs) of the gastrointestinal tract presented with symptoms of GI bleeding. GTs, typically benign lesions of mesenchymal origin, are rarely seen in the GI tract, and most commonly involve the distal appendages. This case series discusses the tumor biology, presentation, imaging, endoscopic findings, pathology and management of GTs. While diagnosis of GTs is typically made on final surgical pathology, there are defining characteristics that can separate a GT from a gastrointestinal stromal tumor on endoscopic ultrasound (EUS) and CT imaging. The classic pathological findings are discussed, and surgical decision-making is reviewed. New developments in the form of EUS-guided biopsy and endoscopic submucosal dissection present new avenues for diagnosis and treatment of submucosal lesions of the GI tract, including GTs. While typically a benign tumor requiring no adjuvant therapy, this study discusses some very rare cases of metastatic GT in the literature.

Radiological Diagnosis and Approach: Glomus Tumour at Finger Tip

A Glomus tumor is a rare benign neoplasm arising from the glomus body which is a neuroarterial structure and mainly found under the nail, on the fingertip or in the foot. We present here a case of a 60 Year old female with a long history of pain in her left Index finger. She underwent radiological investigations of Skiagram Hand, High resolution ultrasonography with color Doppler of Local Region (Finger), and MRI Finger; thereby diagnosis of glomus tumor was made. Subsequently it was surgically removed; Histopathological result was consistent with glomus tumour.DOI: http://dx.doi.org/10.3126/njr.v4i1.11370 Nepalese Journal of Radiology, Vol.4(1) 2014: 52-55

Glomus Tumor in Vulva with Uncertain Malignant Potential

Glomus Tumor in Vulva with Uncertain Malignant Potential Glomus tumors of female genital tract are rare. Herein we report a case of glomus tumor in the vulva in a 39 years female presenting with a 4 cm painful vulvar growth. The mass was totally excised. The histopathological diagnosis was supported with immunohistochemistry and considering the size of the tumor more than 2 cm, the final diagnosis of glomus tumor with uncertain malignant potential was made. After the excision, the patient had no recurrence, on follow up. To the best of our knowledge only very few cases of glomus tumor with uncertain malignant potential have been described in vulva till date.

The diagnosis and management of glomus tumors in the finger-pulp

Objective To study the diagnosis,surgical treatment and pathological analysis of glomus tumors in the finger-pulp and reduce the post-resection recurrence rate. Methods Between February 2002 and December 2010,15 cases were diagnosed with glomus tumor in the finger-pulp.Clinical manifestations included localized pain,positive Love's pin test and a cold sensitivity test.Ultrasonographic imaging and MRI were acquired before the operation.The glomus tumor was completely removed by surgical resection and subjected to histological examination, Results All 15 cases were follow-up for an average of one year.There was no recurrence of the tumor.All the preoperative symptoms and signs disappeared.Pathology confirmed the diagnosis of glomus tumor in all the cases. Conclusion Preoperative Love's pin test,ultrasonographic imaging and MRI were useful in the diagnosis.Complete surgical removal of the glomus tumor along with its outside capsule could reduce the recurrence rate. Key words: Glomus tumor; Pathology,surgical; Finger-pulp

Glomus tumours in the skin and subcutis of three horses

Three horses presented with variably painful, nonulcerated masses of the head or neck that were diagnosed as glomus tumours. Grossly, they were fleshy, pink to tan masses ranging from 0.4 to 9 cm in diameter, involving either the deep dermis and subcutis or the subcutis and underlying skeletal muscle. Microscopically, neoplastic epithelioid cells were arranged in sheets, cords and packets within lobules. The neoplastic cells frequently abutted and formed nodular bulges into large endothelium-lined vascular spaces, especially around the tumour periphery. Large nerve branches were associated with each tumour. As determined by immunohistochemistry, the neoplastic cells consistently expressed α-smooth muscle actin and vimentin, and some cells in two of the cases expressed desmin. A laminin- or collagen IV-positive basement membrane was demonstrated around individual tumour cells or small groups of cells in all three cases. Morphological features and immunohistochemistry supported the diagnosis of glomus tumour, most consistent with the solid type in humans. Applying a classification system used in humans, two of these tumours met criteria of malignancy (glomangiosarcomas). One horse was euthanized due to complications associated with recurrence and treatment-related necrosis and secondary infection.

Imaging features of glomus tumors

To describe the imaging findings with pathologic correlation and clinical presentation of glomus tumors. We retrospectively searched the surgical pathology database from January 1, 1997, to April 30, 2010, for cases of pathologically proven glomus tumor. Patients who had imaging results available for review were included in the study. Glomus tumors presented with a prolonged history of focal and often debilitating pain, with a mean duration of symptoms of 7.2years. Mean tumor size was 13mm. The upper extremity was involved in 12/25 (48%) of the tumors, the lower extremity in 12/25 (48%), and one case (4%) was within the trachea. Lesions appeared well circumscribed on ultrasonography, with marked vascularity on color Doppler evaluation. Magnetic resonance imaging (MRI) with a marker placed in the region of point tenderness was the best method for identifying small glomus tumors. These tumors had a high T2 signal and uniform enhancement after gadolinium administration. The diagnosis of glomus tumor is suggested by imaging features of a small circumscribed mass at the site of point tenderness that show marked vascularity on Doppler evaluation or diffuse contrast medium enhancement on MRI, or both. Early tumor recognition allows surgical resection that completely resolves the crippling, chronic pain of these lesions.

Mediastinal Glomangioma

The glomus body is a neuromyovascular, arteriovenous structure primarily found in the skin and, less commonly, other organs, and is involved with thermoregulation. Neoplasms of the glomus organ are most commonly encountered in the skin and soft tissues of the extremities, particularly the subungual region. Glomus tumors are rare vascular neoplasms originating from the glomus body resulting from proliferation of modified muscle cells within this organ. Glomus tumors are commonly subdivided, based on the prominence of glomocytes, vascular structures, and smooth muscle cells, into solid glomus tumors (the most common variant), glomangioma, and glomangiomyoma. Previous reports of intrathoracic glomus tumors have shown that these tumors are most commonly encountered within the tracheobronchial tree or pulmonary parenchyma; mediastinal lesions are exceptionally rare. On the basis of imaging appearance of the glomangioma reported in this case as well as prior reports of tracheobronchial and pulmonary glomus tumors, mediastinal glomus tumors manifest as intensely enhancing masses with circumscribed or poorly defined margins, closely resembling thymic carcinoid tumor, pheochromocytoma, or hypervascular lymphadenopathy. Secretion of catecholamines and tracer uptake on Indium-111 octreotide scintigraphy, as seen in the present case, is probably exceptional. Because glomus tumors may be difficult to diagnose on routine histopathologic specimens, radiologists should be aware of this rare lesion and consider the diagnosis of glomus tumor when an intensely enhancing mediastinal mass is encountered.

Multiple glomus tumors

Solitary and multiple glomus tumors are vascular tumors arising from glomus cells. These two forms have distinct clinical and histopathological features, suggesting that they might have a different pathogenesis. The multiple form is less frequent than the solitary form. Its diagnosis and treatment are more problematic and often delayed. We present the case of a 40-year-old patient, with a 20-year history of numerous non-tender disseminated blue papules. At the age of 30 years one of the lesions was excised and than regrew and became painful. The histological exam of the lesions was consistent with glomangioma, also known as glomus tumor. We performed surgical resection of the nodular and painful lesions. The diagnosis of glomus tumor is easily suspected when the lesion is painful located in the subungual region. However, if the lesions are multiple and extradigitally located, the clinical diagnosis may be difficult and requires having in mind this differential diagnosis. Our case also shows that glomus tumors may regrow after excision in the same location.

Tumor glômico subungueal: estudo epidemiológico e retrospectivo, no período de 1991 a 2003

FUNDAMENTOS: O tumor glômico subungueal é neoplasia benigna de células glômicas. É mais freqüentemente observado como lesão solitária na falange distal dos quirodáctilos, representando de um a 4,5% das neoplasias das mãos. OBJETIVO: Avaliar os aspectos epidemiológicos e clínicos, os exames complementares, bem como prognóstico e tratamento com base em exames histopatológicos e métodos de imagem. MÉTODO: Foram estudados 20 casos de tumor glômico subungueal ocorridos no período de 1991 a 2003, nos ambulatórios de Dermatologia do Hospital das Clínicas e do Hospital do Servidor Público Municipal de São Paulo. RESULTADOS: Os achados epidemiológicos deste estudo não diferiram significativamente do levantamento bibliográfico pesquisado. Confirmaram-se, na casuística analisada, preferência pelos quirodáctilos e maior acometimento em pacientes do sexo feminino. Histologicamente, os dados obtidos foram similares aos existentes na literatura. CONCLUSÕES: Os métodos de imagem não foram utilizados de maneira sistemática como auxiliares diagnósticos do tumor glômico, embora sejam de grande importância na confirmação e delimitação do tumor, especialmente a ressonância magnética de alta definição. As recidivas, consideradas raras, ocorreram em 15% dos casos, enfatizando a necessidade de acompanhamento pós-cirúrgico prolongado.

Aberrant Internal Carotid Artery in the Middle Ear: A Case Report

Aberrant internal carotid artery is a rare vascular anomaly of the temporal bone. The differential diagnosis must be done with glomus tumor and other vascular malformations. We present a case of aberrant internal carotid artery in a young woman with a nonpulsatile tinnitus and normal hearing. A blue-reddish mass behind the tympanic membrane was disclosed; the diagnosis of glomus tumor was suspected. CT scan, MRI, and angiography showed an aberrant internal carotid artery. A correct diagnosis is important. A misinterpretation may lead to a surgical treatment with fatal complications.

Gastric glomus tumor: A hypervascular submucosal tumor on power doppler endosonography

Gastric glomus tumors are rare submucosal lesions that typically occur in the fourth endosonographic layer. We describe a 69-year-old patient who presented with intermittent epigastric pain and in whom a submucosal tumor was encountered during upper gastrointestinal endoscopy. Endosonography revealed a heterogeneous, hypoechoic fourth-layer tumor. Power Doppler imaging revealed prominent intratumoral vascular signals demonstrating its hypervascular nature. A diagnosis of glomus tumor was made via histopathologic evaluation of the resected tumor.

Malignant Tracheobronchial Glomus Tumor

Purpose: To report the computed tomography (CT) findings and short-term follow-up of a patient with malignant bronchial glomus tumor. Methods and Results: The glomus body is an organ found in the skin and thought to be involved in blood flow and temperature regulation. Neoplasms of the glomus body are usually benign and usually affect the palm, wrist, forearm, and foot. Glomus tumors are rarely found in the tracheobronchial tree. Methods and Results: The histopathological diagnosis of glomus tumors can occasionally be difficult. The lesion may resemble carcinoid tumor histopathologically, although immunohistochemical stains and ultrastructural studies, if obtained, are diagnostic. We encountered a patient with a malignant glomus tumor occluding the left mainstem bronchus. The lesion showed intense enhancement on CT, closely resembling a carcinoid tumor. Virtual bronchoscopic imaging showed complete occlusion of the left lower lobe bronchus. The lesion was biopsied with flexible bronchoscopy and partially resected with rigid bronchoscopy and laser therapy. Follow-up CT showed reduction in tumor size.

Glomus Tumor of the Duodenum

We describe a rare case of glomus tumor of the duodenum. The tumor was detected in a 46-year-old man being investigated for episodes of gastrointestinal bleeding. The excised specimen showed a 2.3 x 1.5 x 1.5 cm gray-tan tumor involving the mucosa and the submucosa. The overlying mucosa was focally ulcerated. Histologically, the tumor had a solid pattern of sharply demarcated, round glomus cells with prominent pericytoma-like vessels of varying sizes. The neoplastic cells stained for vimentin, smooth muscle actin, and focally for synaptophysin. These histologic and immunohistochemical features are consistent with a diagnosis of glomus tumor of the duodenum.

Glomus Tumor of the Trachea: Value of Multidetector Computed Tomographic Virtual Bronchoscopy

Glomus tumor of the trachea is extremely rare. We report a case of tracheal glomus tumor in a 39-year-old man who presented with hemoptysis. The diagnosis was made after bronchoscopic biopsy of a tumor involving the posterior wall of the upper trachea. Thin-section multidetector computed tomography of the chest was performed before surgical resection, with multiplanar re-formations and 3-dimensional virtual bronchoscopic reconstruction. Tracheal sleeve resection with reconstruction was successful, and pathological studies confirmed complete resection and the diagnosis of glomus tumor. The patient was disease-free 3 months postoperatively. To our knowledge, this is the first reported case in which additional computed postprocessing was used to help evaluate the extent of such a tumor.

四肢軟部腫よう診断におけるドップラー超音波検査の有用性

The aim of this study was to evaluate the efficacy of Doppler ultrasonography (US) with very high frequency transducers on assessing soft-tissue masses.We performed sonographic evaluation with an ATL HDI-5000 equipped with a 12.5-MHz linear transducer. Images were obtained in 70 patients admitted to our hospital. We applied Sono-CT as a new variation of compound sonography. Sono-CT provides compound images by combining the images obtained by electronically directing the transducer to scan from multiple angles.In this study, we found that US was able to depict softest tissue masses in detail. All tumors were shown as hypoechoic masses, except lipoma. Particularly, US was useful to diagnose certain neural or fatty tumors, and it was proven to help modality the most in the diagnosis of glomus tumors, since its vascularity can easily be detected using this device. In addition, US was not hampered by metal-induced artifacts. Moreover power (color) Doppler imaging was a valuable adjunct in differentiating malignant tumors from benign ones. US offers many advantages in the assessment of soft-tissue masses. This examination is thought to be sensitive, widely available, noninvasive, and less expensive.

Glomus tumors in the fingers: diagnosis with US.

To the author's knowledge, no direct imaging technique has been used routinely in the diagnosis of glomus tumors. Twelve patients with proved glomus tumors of the fingers were examined with high-resolution real-time ultrasound (US). US depicted the tumor preoperatively in nine patients (75%). All detected tumors were hypoechoic on US scans. The smallest tumor detected was 3 mm in diameter. A limitation of US is in the detection of small, flattened subungual lesions. These preliminary observations indicate that US imaging with high-frequency transducers is useful in both the diagnosis and the preoperative three-dimensional localization of glomus tumors.

Solid glomus tumor of the pterygoid fossa: A lesion mimicking an epithelial neoplasm of low-grade malignancy

An example of a solid glomus tumor occurring in the pterygoid fossa is described. Despite its epithelial appearance on light microscopy, the tumor was of connective tissue origin. The diagnosis of glomus tumor was based on characteristic cytologic, ultrastructural, and immunohistochemical features, but the unusual site of the tumor made the diagnosis difficult.

Glomus tympanicum tumors.

TINNITUS is a common otologic complaint. It is difficult to decide which type of tinnitus should be more thoroughly evaluated. Unilateral tinnitus is a symptom that may indicate serious disease such as an acoustic neuroma. When the sound is pulsating, as well as unilateral, one must be suspicious of a glomus tumor. If a mass is seen behind the eardrum of a patient with unilateral pulsating tinnitus, a diagnosis of glomus tumor is almost certain. Biopsy of the mass is not indicated. Further evaluation of the patient, therefore, should be directed toward establishing the size and extent of the tumor so that the appropriate surgical procedure can be planned. The purpose of this paper is to outline the approach to diagnosis and treatment of these tumors in the Otologic Medical Group. Management of Glomus Tumors Glomus tumors of the temporal bone arise from glomus structures situated along Jacobson's nerve or