Glomus Tumor Research Articles

Glomus tumor of gastric antrum: A rare differential

Introduction: Gastric glomus tumor is a rare clinical entity. Surgical excision could be avoided in selected patients if the diagnosis of glomus tumor could be made preoperatively. Cross-sectional imaging and endoscopic ultrasound (EUS) provide vital clues to nudge us in the right direction; however, these are inconclusive. Histopathology remains the gold standard for diagnosis of this condition. Case Report: We report a case of a man in his 60s who presented to the surgical outpatient clinic with long-standing history of abdominal bloating and discomfort. Upper gastrointestinal endoscopy revealed a submucosal lesion, and contrast-enhanced computed tomography (CECT) of the abdomen revealed a homogeneously enhancing lesion in the antrum of the stomach. Following successful surgical excision, histopathological examination established the diagnosis of gastric glomus tumor. This case presentation elaborates on the clinical features of this rare clinical entity and the various options available for diagnosis and management. Conclusion: Glomus tumors are rare mesenchymal tumors that need to be differentiated from other submucosal lesions and should be considered as a differential for submucosal lesions in the distal stomach. Endoscopic ultrasound and CT findings may provide clues to guide us toward the diagnosis; however, diagnosis can be confirmed only with histopathology. Surgical excision with negative margins either by laparoscopic or open operation is the treatment of choice.

Anatomical Variations of the Jugular Bulb: A Critical and Comprehensive Review.

Background and Objectives: The jugular bulb (JB) is the uppermost part of the internal jugular vein receiving the sigmoid sinus. The aim of the present research is to aid the comprehension of the JB, its abnormalities, and surrounding structures for improving both academic and surgical awareness. Materials and Methods: Various studies on this topic were critically reviewed. Cone-beam CT scans and CT and MR angiograms were used to demonstrate each type of the discussed variations. Results: Variations in the JB anatomy were thoroughly documented: high JB, dehiscent JB, hypoplasia and hyperplasia, and diverticula of the JB, as they have significant clinical implications, particularly in the context of otological and neuro-otological surgery, skull base pathology, and diagnostic imaging. Definitions and critical arguments were also specified to clarify existing literature. Additionally, we present a case report illustrating a high and dehiscent JB, an anatomical variation of clinical interest due to its potential for misdiagnosis as a glomus tumor. Another case describes a dehiscent JB with a hypotympanic air cell protruding into it, further highlighting the variability of this condition. Conclusions: It is necessary to proceed with caution when observing abnormal morphological characteristics of the JB. Preoperative assessment of each case is essential for optimal outcomes.

Glomus tumor of the forearm with unusual intraoperative features: a case report

Glomus tumor of the forearm with unusual intraoperative features: a case report

A case of malignant glomus tumor in the mandible

A case of malignant glomus tumor in the mandible

A case of malignant gastric glomus tumor and literature review: A case report.

Malignant gastric glomus tumor (GGT) is an extremely rare malignant tumor of mesenchymal origin, it affects the patient's health and even threatens life. Malignant GGT with vascular invasion is even more rarely reported in the available literature without a prognostic study. So, in this case, we report a malignant GGT with vascular invasion and performed a 5-year postoperative follow-up. To the best of our knowledge, we report the first case of malignant GGT with vascular invasion without recurrence 5 years after surgery. This provides examples and lessons for the treatment of malignant GGT with vascular invasion. A 49-year-old male was admitted to the hospital with gallbladder stones found on health check. After completing abdominal CT and ultrasound gastroscopy, a mass in the gastric antrum was found. The diagnosis of malignant GGT was confirmed by combination of postoperative pathology with positive immunohistochemistry for SMA, vimentin, synaptophysin, H-caldesmon, and calponin, mitosis > 10/50 HPF and moderate-to-severe nuclear atypia. On the 6th day of hospitalization, the patient underwent laparoscopic distal gastrectomy and cholecystectomy. The patient was discharged successfully 1 week after surgery and was followed up for 5 years without recurrence. Malignant GGT can be asymptomatic. For malignant GGT without distant metastasis, despite the presence of vascular invasion, negative margin surgery can still be the standard surgical radical treatment.

Musculoskeletal glomus tumor: a review of 218 lesions in 176 patients.

To review the spectrum of clinical and imaging features of glomus tumor involving the musculoskeletal system including the typically solitary forms as well as the rarer multifocal forms (glomuvenous malformation and glomangiomatosis). A retrospective review of our institutional pathology database from 1996 to 2023 identified 176 patients with 218 confirmed glomus tumors. Primary imaging studies included MRI (125), radiographs (100), clinical/intraoperative photos (77), and ultrasound (36). Lesions were divided into two groups: those that are typically solitary involving specific anatomic areas (finger, toe, soft tissue, coccyx, and bone), and those that are multifocal (glomuvenous malformation and glomangiomatosis). The finger was the most frequently involved anatomic location for the classic (sporadic) glomus tumor occurring in 51% of patients, 77% of which were women, with the nail plate involved in more of the 75% of cases. Sporadic lesions involving the skin, subcutaneous adipose tissue, and deep soft tissue were termed "soft tissue," and were identified in 39% of patients, 90% of which were in the extremities and in men in 81% of cases. The multifocal syndromic forms of glomus disease occurred in younger individuals and involved less than 6% of the study group. Patients with glomuvenous malformation presented early with predominantly cutaneous involvement, while those with glomangiomatosis present later, often with both superficial and deep involvement, and a high rate of local tumor recurrence. While glomus tumor is generally uncommon, it frequently involves the musculoskeletal extremities. Knowledge of the spectrum of characteristic locations and appearances will facilitate definitive diagnosis.

Extra-digital glomus tumour of the forehead: a case report of a solitary solid histopathologic subtype

Background: Glomus tumours (GT) are benign neoplasms that develop from neuro-myoarterial structures known as “glomus bodies” involved in temperature and blood pressure control. GT rarely occur in the head and neck region, and the specific location of the glomus tumour on the forehead is even more uncommon. Case presentation: We report the case of a 36-year-old female who presented with painless swelling on the forehead of one year duration with a progressive increase in size. Physical examination showed a small forehead swelling with an initial clinical diagnosis of a sebaceous cyst. The patient had local excision of forehead swelling which was submitted for histopathologic examination. Discussion: The initial histological differential diagnosis included glomus tumour, benign skin adnexal tumour and PEComa. The formalin-fixed-paraffin embedded tissue blocks of the lesion were then subjected to immunohistochemical analysis. The tumour cells were negative for cytokeratin and positive for SMA and S100. Based on the morphology and immunohistochemical staining characteristics of the tumour cells, a diagnosis of glomus tumour was made. Conclusion: Glomus tumour occurring on the forehead is uncommon. Therefore, a high index of suspicion is needed for diagnosis. Immunohistochemistry may be needed to confirm the diagnosis and rule out other close differential diagnoses.

From diagnosis to recovery – a detailed case report on a nail bed glomus tumor

Introduction and aim. Glomus tumors represent benign neoplastic proliferations of the glomus body, an integral thermoregulatory component within the cutaneous microvasculature. Although they can manifest at various anatomical sites, they are predominantly observed in the subungual region. The tumors present as painful, firm, purplish, solitary nodules of the extremities, especially in the nail bed. They may be solitary or multiple; solitary lesions are encapsulated and most commonly subungual, while multiple tumors are unencapsulated and rarely subungual. Description of the case. Here, we present a case of multiple glomus tumors of the right hand in an 18-year-old female who presented with complaints of painful bluish discoloration of the right little finger for six years and progressive asymptomatic nodules on the right index finger for six months. A clinical examination revealed acute tenderness in both fingers. Love’s pin test and Hildreth’s test were positive. Excision of all lesions was done and sent for histopathology, which confirmed the diagnosis. The patient was symptom-free immediately following surgery. No nail deformities were noticed, and there was no recurrence of symptoms after one year of follow-up. Conclusion. The transungual approach is a safe and effective minimally invasive surgical technique for the treatment of symptomatic nail bed glomus tumors. It offers high success rates, promising cosmetic outcomes, and minimal complications. However, careful patient selection and meticulous surgical technique are essential to avoid potential nail deformities.

Multiple glomus tumours: Clinical, ultrasonographic and histopathologic findings of a rare disease.

Glomus tumour is a rare benign neoplasm originating from the glomus body, clinically presenting as a violet-coloured, painful nodule more sensitive when exposed to cold or hot. This hamartoma is typically solitary and predominantly affects the limbs, extremities and nail beds. Theappearance of multiple tumours and lesions not placed in the extremities is rare and frequently misdiagnosed. At dermoscopy, it appears as ahomogeneous, structureless, purplish area surrounded by a whitish region. Skin ultrasound shows a well-defined, round, hypoechoic mass. We report a case of numerous blue-purplish painful nodules distributed inthe trunk and arms while sparing the extremities, with typical dermoscopy and ultrasound findings. A biopsy was performed, confirming thediagnosis of glomangioma. We call attention to this rare condition to help dermatologists make this diagnosis when facing multiple painful nodules.

Diagnostic and Therapeutic Insights into Spinal Glomangioma of a Unique Intradural, Extramedullary Presentation-Systematic Review.

Contemporary literature lacks examples of intradural, extramedullary spinal glomangiomas. Moreover, glomus tumors in general are exceedingly rare among benign spinal tumors and are mostly located within epidural space or within intervertebral foramen, and only a few cases have been documented to date. This report provides a detailed analysis of the clinical presentation, imaging characteristics, surgical intervention, and pathological findings of a 45-year-old patient experiencing progressive locomotor deterioration. The tumor was surgically excised, and subsequent histological examination identified it as a representative of glomus tumors-a glomangioma. Notably, this represents a unique case as it was the first example of such a tumor being discovered intradurally. Radical surgical excision remains the modality of choice in most benign spinal tumors of this localization. Although the malignant transformation of glomus tumors within the spine has not been documented thus far, cases have arisen in other areas. Consequently, we will investigate potential oncological treatments for cases with malignant potential and highlight advancements in surgical techniques for benign intradural spinal tumors.

Primary glomus tumor of the thymus in a 66-year-old patient

We report a unique case of a 66-year-old man who was incidentally identified to have a mass in the thymus region by computerized tomography scan. CT revealed a well-defined 1.6 × 1 × 0.9 cm thymus mass with moderate uniform enhancement. Thoracoscopic thymectomy was performed, and the pathological diagnosis was primary glomus tumor of the thymus. There were no atypia or malignant histological features, and no primary tumors in other sites. To our knowledge, this is the first case of primary thymic glomus tumor reported in the literature.

Multiple Location of the Glomic Tumor in Children: About a Case

Multiple Location of the Glomic Tumor in Children: About a Case

Rare presentation of gastric glomus tumor in a 28-year-old female with gastritis

Rare presentation of gastric glomus tumor in a 28-year-old female with gastritis

Glomus tumor of the great toe: An uncommon case report

Introduction: Masson’s glomus tumor is a neuromyoarterial hamartomatous proliferation that develops from corpuscules located at the dermal-hypodermal junction, it is a rare but not exceptional benign tumor and it is less frequently reported in the foot. Case presentation: We present a unique case based on its unusual location, clinical presentation (pain being the primary symptom) and its misleading appearance on MRI. Treatment involved surgical excision of the tumor, resulting in a favorable outcome. Histopathological examination of the excised specimen remains crucial for definitive diagnosis, highlighting the importance of considering this unusual location in the differential diagnosis. Discussion: Pathogenesis remains poorly understood, and diagnosis can be difficult. It preferentially affects the hands (75%) and it is subungual in 50% of cases. Diagnosis is based on the clinical triad of sensitivity, pain and intolerance. Advances in high-resolution MRI have improved false negatives, with lesions showing hypo-signal in T1 and hypersignal in T2, with clear contrast between normal tissue and tumor. Diagnostic certainty is provided by histology. After complete removal of the tumor, results are generally considered excellent. In most cases, pain disappears rapidly, and the affected finger or limb returns to normal within three months. Conclusion: Glomus tumors are certainly rare, but not exceptional, and a high degree of suspicion is required when faced with a painful purplish nodule. Usually distal, periungual in location, they can occur anywhere, with sometimes unusual and puzzling localizations.

Thoracoscopic enucleation of an esophageal glomus tumor in the prone position: a case report and literature review

BackgroundGlomus tumors (GT) generally occur in the skin. However, esophageal GT, an extremely rare condition, has no established standardized treatment guidelines. Herein, we report the case of an esophageal GT successfully removed by thoracoscopic enucleation in the prone position using intra-esophageal balloon compression.Case presentationA 45-year-old man underwent an annual endoscopic examination and was found to have a submucosal tumor in the lower esophagus. Endoscopic ultrasound (EUS) revealed a hyperechoic mass originating from the muscular layer. Contrast-enhanced computed tomography identified a 2 cm mass lesion with high contrast enhancement in the right side of the lower esophagus. Pathologic findings of EUS-guided fine needle aspiration biopsy (EUS–FNA) revealed round to spindle shaped atypical cells without mitotic activity. Immunohistochemically, the tumor was positive for alpha-smooth muscle actin, but negative for CD34, desmin, keratin 18, S-100 protein, melan A, c-kit, and STAT6. He was diagnosed with an esophageal GT and a thoracoscopic approach to tumor resection was planned. Under general anesthesia, a Sengstaken–Blakemore (SB) tube was inserted into the esophagus. The patient was placed in the prone position and a right thoracoscopic approach was achieved. The esophagus around the tumor was mobilized and the SB tube balloon inflated to compress the tumor toward the thoracic cavity. The muscle layer was divided and the tumor was successfully enucleated without mucosal penetration. Oral intake was initiated on postoperative day (POD) 3 and the patient discharged on POD 9. No surgical complications or tumor metastasis were observed during the 1-year postoperative follow-up.ConclusionsAs malignancy criteria for esophageal GT are not yet established, the least invasive procedure for complete resection should be selected on a case-by-case basis. Thoracoscopic enucleation in the prone position using intra-esophageal balloon compression is useful to treat esophageal GT on the right side of the esophagus.

Treatment of familial glomangiomatosis with Nd:YAG laser: a case report

ABSTRACT Familial glomangiomatosis is a rare autosomal dominant vascular malformation caused by a mutation in the glomulin GLMN gene. It is characterized by the appearance of multiple glomus tumors composed of dysmature veins surrounded by glomus cells. We present a case of an 11-year-old girl with familial glomangiomatosis successfully treated with Nd:YAG long-pulse laser. Three sessions of laser treatment were performed, resulting in more than 80% reduction of the lesion and complete disappearance of pain, with no adverse effects reported. This case report demonstrates the excellent risk-benefit ratio of Nd:YAG long-pulse laser in the treatment of familial glomangiomatosis.

Schwannoma of Ansa-Cervicalis: A Rare Location for Schwannoma.

Schwannomas are rare neoplasms that originate from the nervous system. We describe a case of schwannoma of the ansa-cervicalis in a patient where preoperative imaging is suggestive of glomus caroticum tumor. A 44-year-old man presented to the surgical oncology department with a recurrent anterior triangle neck swelling. Magnatic resonance ımaging (MRI) demonstrated right enhancing soft tissue mass at the carotid bifurcation consistent with glomus tumor. Intraoperatively, the lesion was found abuting the bifurcatuion and arising from the right ansa-cervicalis. Histopathology evaluation revealed schwannoma. Schwannoma of the ansa-cervicalis is extremely rare. Very few cases have been reported in the literature. Making the preoperative diagnosis is difficult. Preoperative imaging is necessary to rule out other causes of neck masses such as thyroid lesions, lymphadenopathy, and carotid body tumor. Verocay bodies were noted on histology. Schwannoma of cervical region can have origin from any nerve. Any Neurologic post-operative deficit depends on the nerve of origin and the precision of the surgery performed.

Outcomes of the Transungual Approach in 56 Consecutive Digital Subungual Glomus Tumours.

Background: Glomus tumour is a painful small tumour of the glomus body commonly located under the nail bed. The aim of this study is to evaluate the correlation of clinical diagnosis with MRI findings, determine the prevalence of the tumour at different subungual locations and determine the differences in outcomes (if any) between a longitudinal and a transverse nail bed incision for excision of the tumour. Methods: This retrospective study of 56 subungual glomus tumour was conducted from May 2010 to December 2021. Data with regard to gender, age at presentation, digit involved, presenting symptoms, duration of symptoms, clinical signs, need for MRI, anatomical location, surgical approach (longitudinal versus transverse), histopathology result, period of follow-up and complications were recorded. Results: All 56 (100%) patients presented with classic triad of symptoms. The average duration of symptoms was 52.9 months (range: 3-204 months). Eleven (20%) tumours were in the sterile matrix, 38 (68%) at the junction of sterile and germinal matrix and 7 (12%) in the germinal matrix. The tumours were excised through the longitudinal incision in 31 (55.3%) patients and transverse incision in 25 (44.7%). One (1.8%) tumour was intraosseous that was diagnosed intraoperatively and excised successfully. Average follow-up was 35.4 months (range: 6-120 months). There was no difference in outcomes (pain or nail deformity) between the two incisions. One patient (1.8%) has persistent pain that was due to a missed satellite lesion in the same digit. This was excised later with resolution of symptoms. There were no recurrences and all patients were cured after excision of tumour. Conclusions: Diagnosis of glomus tumour is usually clinical, and most are located at junction of sterile and germinal matrix. Tumour can be excised either by longitudinal or transverse nail bed incisions without any change of treatment outcome. Level of Evidence: Level IV (Therapeutic).

Intra-operative dermoscopy (onychoscopy) of the nail unit-A systematic review.

Dermoscopy of the nail unit (onychoscopy) is a method which allows for non-invasive observation of the nail structures, increasing the accuracy of clinical diagnosis. Currently, it is used in evaluation of both inflammatory and neoplastic conditions of the nail unit. However, in contrast to the skin, the anatomy of the nail unit prevents direct observation of nail bed or nail matrix structure during classic onychoscopy. Intra-operative onychoscopy is a variant of the technique which uses direct visualization of the nail unit structures after nail plate avulsion. The aim of this systematic review was to summarize the current state of knowledge on intra-operative onychoscopy. The MEDLINE, EMBASE and Cochrane databases were systematically searched in January 2024. All types of study designs assessing intra-operative dermoscopy of the nail unit were included in this study. The risk of bias in included studies was assessed using the Joanna Briggs Institute critical appraisal tools. The qualitative synthesis of 19 studies totalling a number of 218 cases in 217 patients included the following entities: melanoma, nevus, hypermelanosis (melanocytic activation), melanocytic hyperplasia, melanophages accumulation, squamous cell carcinoma, glomus tumour, lichen planus, onychomatricoma, onychomycosis and subungual exostosis. The main limitation of the study was a relatively low number of identified studies, most with low levels of evidence. Intra-operative onychoscopy does not replace histologic examination, though it may be useful in determining the modality of surgical diagnostic procedures.

Non-gastrointestinal stromal tumor, mesenchymal neoplasms of the gastrointestinal tract: a review of tumor genetics, pathology, and cross-sectional imaging findings.

There is a diverse group of non-gastrointestinal stromal tumor (GIST), mesenchymal neoplasms of the gastrointestinal (GI) tract that demonstrate characteristic pathology and histogenesis as well as variable imaging findings and biological behavior. Recent advancements in tumor genetics have unveiled specific abnormalities associated with certain tumors, influencing their molecular pathogenesis, biology, response to treatment, and prognosis. Notably, giant fibrovascular polyps of the esophagus, identified through MDM2 gene amplifications, are now classified as liposarcomas. Some tumors exhibit distinctive patterns of disease distribution. Glomus tumors and plexiform fibromyxomas exhibit a pronounced affinity for the gastric antrum. In contrast, smooth muscle tumors within the GI tract are predominantly found in the esophagus and colorectum, surpassing the incidence of GISTs in these locations. Surgical resection suffices for symptomatic benign tumors; multimodality treatment may be necessary for frank sarcomas. This article aims to elucidate the cross-sectional imaging findings associated with a wide spectrum of these tumors, providing insights that align with their histopathological features.