Tumor glómico gigante en un adulto / Giant glomus tumor in an adult

Se describe el caso clínico de un paciente de 61 años de edad, atendido en la consulta de Ortopedia y Traumatología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, por presentar aumento de volumen en el grueso artejo derecho desde hacía más de un año, con elevación y deformidad de la uña, lo cual dificultaba el uso del calzado. Se realizó la exéresis de la uña y de los 2 tercios distales de la falange distal del grueso artejo. Los resultados de los exámenes complementarios efectuados y la evaluación histológica informaron que se trataba de un tumor glómico sin evidencias de malignidad. A los 30 días habían desaparecido completamente las molestias, de manera que se incorporó a sus actividades laborales habituales.

The case report of a 61 year-old patient is described, who was attended in Orthopedics and Traumatology Department of "Dr. Juan Bruno Zayas Alfonso" General Teaching Hospital of Santiago de Cuba, due to an increased volume in the right great toe for over a year, with elevation and deformity of the nail, which prevented him from wearing shoes. Exeresis of the nail and the distal two thirds of the distal phalanx of great toe was performed. The results of complementary tests and histological evaluation revealed a glomus tumor with no evidence of malignancy. At 30 days discomfort had completely disappeared, so that he returned to his usual working activities.

Glomangioma da artéria digital do polegar: relato de um caso / Glomus tumor of digital artery of thumb: case report

Os autores relatam um caso de tumor glômico em ramo da artéria radial que irriga o polegar direito, com história clínica de 4 meses. O doente referia o aparecimento de tumoração de aproximadamente 2,0 centímetros na região interdigital, entre o primeiro e o segundo quirodactilos da mão direita, sobre o músculo flexor curto do polegar, extremamente dolorosa e com dor em progressão. Os exames com aparelho de Doppler bidirecional e o eco-color-Doppler apresentaram, como diagnóstico presuntivo, malformação arteriovenosa, pelo turbilhonamento do fluxo e ausência de estenoses. A tumoração foi retirada por cirurgia aberta e encaminhada para exame histopatológico, com diagnóstico de glomangioma. Este relato descreve uma doença arterial pouco frequente, que causa extremo desconforto ao seu portador, mas que é solucionada pela exerese cirúrgica, sem sequelas.

We report on a case of glomus tumor in the branch of the radial artery of the right thumb. The tumor had a 4-year clinical history. The patient reported the development of a 2.0-cm tumor in the interdigital region between the first and second fingers of the right hand on the short flexor muscle of thumb. The patient also complained of severe and progressive pain. Tests using bidirectional Doppler and echo-color-Doppler revealed a presumptive diagnosis of arteriovenous malformation based on the turbulence of the flow and absence of stenosis. The tumor was removed by open surgery and sent for histopathological examination, which showed a diagnosis of glomangioma. The present report describes a rare arterial disease causing extreme discomfort to the patient, which may be treated with surgical resection without sequelae.

A Case Report of Glomus Tumor of the Nasal Columella

PURPOSE: Glomus tumor is a benign neoplasm of the normal glomus body, occurring as painful subcutaneous nodules, frequently located in the subungual area. There are few cases of facial glomus tumor reported and we report a case of glomus tumor developing on the columella of nose. METHODS: A 68-year-old female presented with a mass of the columella grown for 2 years. The nodule was 0.6 cm in diameter, red-colored without any symptoms such as pain, tenderness and cold hypersensitivity. The pathologic result after punch biopsy was hemangiopericytoma. Excision with local anesthesia was executed. RESULTS: The postoperative recovery of the patient was uneventful, Histopathological examination indicated a glomus tumor. Immunostaining revealed positivity for vimentin, actin, and negativity for desmin, CD-34. After 8 months follow up, there is neither complication nor evidence of local recurrence on clinical examination. CONCLUSION: To accomplish an accurate diagnosis of glomus tumor, the histopathological examination is essential together with immunochemical studies. The differential diagnosis include hemangioma, lipoma, epidermal inclusion cyst, dermoid cyst and arteriovenous malformation in this region. We report a case of glomus tumor on the face with uncommon clinical features.

Malformación venosa glómica / Glomus venous malformation

Malformaciones venosas glómicas son formaciones tumorales derivadas del cuerpo glómico. Se presentan clínicamente como pequeñas lesiones sobreelevadas, color azulado, con síntomas específicos: dolor e hipersensibilidad a la palpación y sensibilidad a la temperatura. Localizan especialmente a nivel distal de las extremidades y con menos frecuencia en otras zonas de cuerpo. Tiene una mayor incidencia en mujeres entre la tercera y cuarta década. Presentamos una paciente de 19 años con glomangiomas múltiples y acantosis nigricans.

Glomus venous malformations are tumors resulting from the glomicbody that present clinically as small lesions over-bluish color, charac-terized by the presence of specifi c symptoms: pain and hypersensitiv-ity to palpation and sensitivity to temperature. They are usually foundon limbs, and less frequently in other locations. They have a higher incidence in women between the third and fourth decades. We present thecase of a 19 year-old female patient with multiple glomangiomas andacantosis nigricans.

A Case of Disseminated Multiple Glomus Tumors

PURPOSE: Glomus tumors are neoplasms that are composed of modified smooth muscle cells of the glomus body and multiple glomus tumor comprises 10% of all glomus tumors. We report a case of disseminated multiple glomus tumors. METHODS: A 14-year-old boy presented with multiple subcutaneous purple nodules on the right cheek, back, right arm, right hand dorsum, right fourth finger, and left ankle. Nodules on the back and right fourth finger were completely excised under local anesthesia and histopathologic examination was followed. RESULTS: Histopathologic findings showed numerous dilated, cavernous-like, thin-walled vascular spaces surrounded by one or a few layers of glomus cells. On immunohistochemical examination, glomus cells stain for smooth muscle actin, and endothelial cells stain for CD31. Those revealed multiple glomangiomas. CONCLUSION: A review of Korean literature revealed only one reported case of disseminated multiple glomus tumors, so this is the second case to be reported in the Korean literature. In case of multiple soft tissue tumors, thorough physical examination and preoperative evaluation are needed.

Multiple Glomus Tumors of the Ankle with Prominent Intranuclear Pseudoinclusions

Glomus tumors are neoplasms that are composed of modified smooth muscle cells of the glomus body. Here, we report a case of multiple glomus tumors of the ankle that showed various histologic types, including the solid type (glomus tumor proper) and angiomatous type (glomangioma). The tumor cells observed in this case also showed prominent intranuclear inclusions, which has not yet been reported in glomus tumors. Ultrastructural examination demonstrated that the nuclear inclusions were not true inclusion bodies but were intranuclear cytoplasmic pseudoinclusions formed by cytoplasmic invaginations that formed as a result of the deep and complex nuclear contours.

A Clinical and Histopathologic Analysis of 27 Cases of Glomus Tumors / 대한피부과학회지

BACKGROUND: Glomus tumor is a benign neoplasm composed of vessels and glomus cells in varying proportion. Histopathologically, this tumor can be subdivided into a solid type glomus tumor, glomangioma, and glomangiomyoma. OBJECTIVE: The aim of this study was to describe the general clinicopathologic features of the glomus tumor. METHODS: We reviewed the medical records and biopsy specimens of 27 cases of glomus tumors which were diagnosed between May 1995 and July 2005 in Samsung Seoul hospital. RESULTS: We compiled clinical data and histopathologic information on the 27 cases of glomus tumor. Male:female ratio was 1:2.4 and the mean onset age was 40.3 years old. The most frequent site of involvement were the fingers (20 cases, of which 17 were the subungal location), followed by the arm (3 cases), leg (2 cases), and foot (1 case). Interestingly, 17 out of 19 female cases involved the fingers, whereas only 3 out of 8 male cases involved the fingers. The most characteristic symptom was paroxysmal pain elicited by pressure in all patients, except one patient who presented with multiple glomus tumors. The most common clinical presentation was nail dystrophy (12 cases), followed by purple or bluish papules (6 cases), nail discoloration (5 cases), and subcutaneous nodules (4 cases). Twenty six cases presented with a solitary lesion, and one patient presented with multiple lesions. Histopathologically, 21 cases were classified as solid type, and 6 as glomangioma type (all glomangioma cases developed in male patients). Edematous and extensive myxoid stromal changes were found in 6 cases (22.2%). CONCLUSION: According to these results, glomus tumors at our clinic were commonly seen as a solitary painful nodule on the finger (especially the subungal location) in female patients and all glomangioma cases were presented in male patients.

A Case of Multiple Glomus Tumors Showing Histopathologic Feature of Glomangiomyoma / 대한피부과학회지

We report a case of multiple glomus tumors showing histopathologic feature of glomangiomyoma with a review of the literature. The patient presented with multiple, tender, subcutaneous nodules on the back, thigh, and arm. Skin biopsy from the back revealed glomangioma. Three years later, new lesions appeared on the waist and soles and pain was noted on the thigh and back lesions. Additional skin biopsy at the same site was performed to reveal glomangiomyoma.

A Case of Glomangioma Treated with Sclerotherapy / 대한피부과학회지

Glomangioma is a kind of glomus tumor showing components of glomus cells and blood vessels. A 12-year-old female visited our department due to a tender 8 X 7 cm sized plaque formed by multiple conglobated nodules that had been growing on the left thigh since her birth. Histopathological findings showed dilated, thin walled vascular spaces surrounded by several layers of glomus cells, compatible with glomangioma. Glomangioma has been treated with surgical excision, laser, and sclerotherapy. We treated her by sclerotherapy in considering size and depth of the lesion. After second sclerotherapy with 1% sodium tetradecyl sulfate, the tender lesion almost disappeared. Sclerotherapy was effective to treat large glomangioma with good cosmetic outcome.

Glomus Tumor:a Clinical and Histopathologic Analysis of 17 Cases

BACKGROUND: Glomus tumor is a benign neoplasm derived from the normal glomus body. This tumor includes the following types; solitary, multiple, proliferating, and acral arteriovenous. Histologically, it was subdivided into solid type, glomangioma, and glomangiomyoma. Its malignant counterpart - glomangiosarcoma - was reported. OBJECTIVES: The purposes of this study were aimed to evaluate the clinical and pathologic presentations of glomus tumor. METHODS: A total of 17 patients who have been diagnosed with glomus tumor by histopathologic examination were reviewed. RESULTS: Male patients were ten and female patients were seven. The age of the onset of glomus tumor varied from birth to 61 years. The location of tumors were as follows: arm (7 cases), finger (6 cases), back (2 cases), leg (1 case), foot (1 case). The digit was the most common site for female patients. Clinical manifestations showed solitary bluish papule (6 cases), subcutaneous nodule (5 cases), nail discoloration (3 cases), nail dystrophy (1 case), bluish plaque (1 case). One patient had no specific lesion but tenderness. The most characteristic symptom was pain in 15 (88.2%) of the 17 patients, and the other two patients had no symptom. Two asymptomatic lesions were located on the forearm and histopathologically showed glomangioma. Histopathologically, 13 (76.5%) of the 17 patients classified as solid type, and 4 (23.5%) the glomangioma variety. CONCLUSION: Glomus tumors were most commonly seen as a painful nodule on the upper extremity and especially female patients showed predilection for subungual location. We speculate that multiple, mild symptomatic lesions might be a tendency to be glomangioma.

A Case of Solitary Glomangioma Occurring on the Right Shoulder / 대한피부과학회지

A 63-year-old man was presented with a tender, solitary nodule on the right shoulder. A biopsy specimen showed various sized irregular vascular lumens in the upper dermis. The vascular walls consisted of an endothelial cell layer and rim of one to three layers of glomus cell nests outside the endothelial cells. The cell nests consisted of round shaped epitheloid cells with relatively uniform round or oval shaped nuclei and pale cytoplasm. These tumor cells were strongly positive for vimentin, and alpha-smooth muscle actin. We report a case of a solitary glomus tumor(glomangioma) that showed the histological features of the multiple type of glomus tumor.

A Solitary Glomangioma:An Immunohistochemical and Electron Microscopic Study

A 62-year-old man presented with a tender, solitary nodule on the left upper arm. He had no specific family history of the lesion. A biopsy specimen showed various sized irregular vascular lumens in the upper dermis. The vascular walls consisted of an endothelial cell layer and rim of one to three layers of glomus cell nests outside the endothelial cells. The cell nests consisted of round shaped epitheloid cells with relatively uniform round or oval shaped nuclei and pale cytoplasm. These tumor cells were strongly positive for vimentin, and a-smooth muscle actin. On electron microscopic examination, the cytoplasm of these tumor cells contained fine filamentous components and many electron dense bodies were found at the plasma membrane and the cytoplasm. We report a case of a solitary glomus tumor(glomangioma) that showed the histological features of the multiple type of glomus tumor. In addition we describe the results of an immunohistochemical and electron microscopic study.