Benign glomus tumor of prostate: a case report.

Glomus tumor (GT) is a neoplastic lesion of mesenchymal origin arising from the neuromyoarterial canal or glomus body. Although most GT occur in the peripheral soft tissue and extremities, these tumors can grow anywhere in the body. Here, we describe an uncommon case of GT involving the prostate.

Glomus tumour located in the volar aspect of distal phalanx of thumb.

A woman in her 40s presented with pain and tenderness over the volar aspect of distal phalanx of her thumb without any swelling or discolouration. MRI indicated a possible glomus tumour. The treatment involved complete excision, and histopathological examination of the excised tissue confirmed the diagnosis of a glomus tumour. Most reported cases of glomus tumours are usually located in either the subungual region or the tip of the finger. This case represents a rare presentation in an unusual location-the volar aspect of the distal phalanx of the thumb.

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.

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).

Nail-preserving excision of glomus tumor in the second toe: Case report and literature review.

INTRODUCTION: This case report describes the diagnosis of a glomus tumor in the second toe of a 38-year-old female, followed by surgical treatment utilizing a transungual approach to preserve the nail. This study highlights the diagnostic challenges and surgical strategies to treat such tumors while preserving nail integrity. PATIENT CONCERNS: Pain occurred once a week, but over time, it increased, and just before seeking medical attention, she experienced pain more than 5 times a day. The pain worsened when cold water touched her toe. DIAGNOSIS: We observed a slight hump indicating nail plate deformity, and the patient exhibited severe pinpoint tenderness (positive Love test) in the affected area. Color duplex ultrasound was performed for further investigation, revealing a hypervascular hypoechoic nodule measuring 0.5 cm in size at the nail bed of the right second toe. INTERVENTION: The surgery was performed under digital nerve block anesthesia using a modified transungual nail-preserving approach for the excision of the glomus tumor. OUTCOMES: The pain that was reported prior to the surgery has improved postoperatively, and the recovery has been uneventful without any other complication. CONCLUSION: This paper provides a comprehensive examination of a rare glomus tumor in the second toe, elucidating both diagnostic intricacies and treatment modalities. It emphasizes the dual necessity of achieving total tumor excision while also considering aesthetic outcomes. The insights presented herein are intended to serve as valuable guidance for clinicians confronted with similar clinical scenarios, underlining the delicate interplay between effective tumor management and the preservation of cosmetic integrity.

Glomus tumor causing chronic finger pain: ischemia test is a reliable clinical sign for the diagnosis. Case report and review of literature.

Glomus tumors are a rare, benign neoplasm arising from the neuroarterial structure known as the glomus body, which is a specialized arteriovenous shunt involved in temperature regulation. They account for less than 2% of soft tissue tumors and between 1% and 4.5% of tumors in the hand.. Despite their first descriptions appearing almost 100 years ago, late and missed diagnoses are common, leading to significant suffering. The classic diagnostic triad includes spontaneous pain, a sensation of pressure and tenderness, and cold hypersensitivity. Magnetic resonance imaging remains the most useful imaging modality. The abolition of pain after inflating a blood pressure cuff above the systolic blood pressure level (ischemia test) is highly diagnostic.Therefore, we suggest the routine use of this simple test in cases of upper limb pain of unclear etiology . Surgical excision is the treatment of choice and is curative.

Rare presentation of a primary intraosseous glomus tumor in the humerus of a teenager.

A glomus tumor is a benign mesenchymal tumor comprised of cells that resemble the perivascular modified smooth muscle cells of the glomus body. Glomus tumors typically appear in the superficial lesions of the soft tissue in the extremities, such as the subungual region. However, their occurrence in the bone is rare, with only about 30 cases reported to date. Half of these cases involved the distal phalanges of the fingers or toes, with only three reported cases involving the long bones. Here, we present the first case, a primary glomus tumor in the humerus of a 14-year-old female. An osteolytic and cystic lesion was detected after a pathological fracture occurred during exercise. Despite the tumor's large size, no pathological findings indicated malignancy. The fracture healed through conservative treatment, while the tumor was effectively managed with curettage. Appropriate medical care can be provided to patients by focusing on pathological findings.

En Bloc Excision and Bone Grafting for Monostotic Multiple Intraosseous Glomus Tumors of the Distal Phalanx: A Case Report.

CASE: Glomus tumors of the hand are rare tumors that occur predominantly in the subungual region. Though multicentric glomus tumors have been reported in the subungual region involving the nailbed, monostotic multiple intraosseous glomus tumors have not been reported so far. We report a case of a 36 year-old woman who presented with a 5-year history of intermittent thumb pain, aggravated with exposure to cold or pressure. A glomus tumor of the thumb was excised, but symptoms returned 3 months later. She ultimately underwent curettage with bone grafting of a recurrent glomus tumor at the same site, and has been free of symptoms for 1.5 years. CONCLUSION: Intraosseous glomus tumors may present as multiple synchronous lesions. This, to the best of our knowledge, is the first case report of monostotic multiple intraosseous glomus tumors.

Gastric glomus tumor on EUS-FNA-based cytology: clinicopathologic and immunohistochemical features of 4 cases, including 1 case with associated MIR143HG-NOTCH2 fusion gene.

INTRODUCTION: Gastric glomus tumor (GT) is a rare submucosal tumor for which the preoperative diagnosis can be challenging. We report the cytomorphologic and immunohistochemical features of 4 gastric GTs diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) cytology. MATERIALS AND METHODS: Files were searched to identify gastric GTs diagnosed by EUS-FNA between 2018 and 2021. A total of 4 cases of gastric GTs (3 men and 1 women; mean age, 60 years) were included. RESULTS: Three GTs were located in the gastric antrum and one in the gastric body. Their size ranged from 2 to 2.5 cm. Three patients presented with epigastric discomfort and one with chest wall discomfort. Rapid on-site evaluation was performed for 3 cases; the findings for all 3 were indeterminate. The smears were moderate to highly cellular and showed loose clusters of evenly distributed small- to medium-size bland tumor cells. The tumor cells had centrally located round to oval nuclei with inconspicuous nucleoli and scant to moderate amount of eosinophilic to clear cytoplasm. Examination of the cell blocks revealed branching small vessels surrounded by small- to medium-size cells. The neoplastic cells were positive for smooth muscle actin and synaptophysin and negative for AE1/AE3 and S-100. C-KIT and CD34 were variably positive. Ki-67 was <2% positive. In 1 case, the fusion panel-solid tumor (50 genes) revealed the MIR143HG-NOTCH2 fusion gene. CONCLUSIONS: Smears and cell block preparation revealed angiocentric sheets of uniform, small round to oval tumor cells with pale to eosinophilic cytoplasm, intermingled with endothelial cells. The differential diagnosis of gastric GTs on rapid on-site evaluation includes neuroendocrine tumors and epithelioid or spindled cell neoplasms. Immunohistochemical and molecular studies can be helpful in the preoperative diagnosis of gastric GT.

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.

Comparison of Subungual Glomus Tumours in Terms of Nail Aesthetics and Recurrence According to Size and Location in the Germinal or Sterile Matrix.

PURPOSE: The aim of this retrospective study was to investigate the effect of subungual glomus tumour size and localization in the germinal or sterile matrix on tumour recurrence and aesthetic outcomes. PATIENTS AND METHODS: From 35 patients who underwent surgery for a subungual glomus tumour between February 2013 and February 2020, 26 patients - 17 women and 9 men - with 27 subungual glomus tumours fulfilled the inclusion criteria. The average age was 37.3 (22-58) years. According to the patients' surgical notes and preoperative magnetic resonance images 14 tumours were located in the sterile, 13 in the germinal matrix, and the mean size of the glomus tumours located in the germinal matrix was 4.9±1.7 mm, in the sterile matrix 3.6±1.0 mm. At the postoperative 12th month follow-up visit nail aesthetic was evaluated objectively according to Zook's fingernail appearance scoring. In addition, patients were asked to evaluate the pain and nail appearance in the involved finger by VAS (Visual Analog Scale 0-10). Patients who experienced recurrence were noted. RESULTS: No significant Zook's fingernail appearance score differences were observed between germinal and sterile matrix groups (p=0.097). Comparison of VAS score for pain and VAS score for nail appearance between the two groups also yielded similar values (p=0.449 and 0.395, respectively). The recurrence rate was similar at both locations (p=0.557) with 3 recurrences in the germinal, and 2 in the sterile matrix group. There was no relation between tumour size, Zook's fingernail appearance score (p=0.874) and recurrence (p=0.784). The observed germinal matrix glomus tumours were significantly larger than the sterile matrix tumours (p=0.031). CONCLUSION: Neither subungual glomus tumour size nor localization in the germinal or sterile matrices has different effects on nail appearance and recurrence.

Glomus tumours of the knee: a case series.

AIM: To review clinical and magnetic resonance imaging (MRI) features of patients with glomus tumour of the knee, and compare the present findings with cases from the English literature. MATERIALS AND METHODS: The orthopaedic oncology and pathology databases at The University of Chicago were reviewed for cases of glomus tumour and small subcutaneous anterior knee masses. For all glomus tumours, the site of the tumour and age and sex of the patient were recorded. For those tumours arising in the knee, the symptom profile and MRI characteristics were recorded. The English literature was reviewed for cases describing glomus tumours in the knee. RESULTS: Thirty-four patients with glomus tumour were recorded. Five glomus tumours occurred in the anterior knee, all in men aged ≥30 years, four of whom had a several-year history of pain prior to diagnosis. MRI showed small (<2 cm) nodular enhancing masses. Review of the English literature supports the anterior knee as a common location for lower-extremity glomus tumours, with a male predominance and several years of pain preceding diagnosis. CONCLUSION: Although rare, glomus tumours occur in the knee. Unlike the classic description of glomus tumours occurring in the fingers most typically in women <30 years of age, those that occur in the knee tend to do so in men >30 years, and many years of pain can precede diagnosis. The astute radiologist may be the first to suggest this diagnosis if a small, painful, enhancing, nodular subcutaneous mass is noted on knee MRI examinations.