Malignant glomus tumor of the intestinal ileum with multiorgan metastases:A case report and review of literature

BACKGROUND Glomus tumors(GTs)are rare mesenchymal neoplastic lesions derived from cells of the glomus body.GTs rarely occurs in the visceral organs,where there may be few or no glomus bodies,and the majority of GTs are benign,rarely demonstrating aggressive or malignant behavior and histological features.CASE SUMMARY We report a patient with malignant GTs of the intestinal ileum with multiorgan metastases who was admitted due to moderate anemia.Capsule endoscopy revealed a bleeding mass in the intestinal ileum,and the patient underwent segmental ileal resection through laparoscopic surgery.The histopathological and immunohistochemical diagnoses were consistent with malignant GT.Longterm follow-up showed that the GT had metastasized to multiple organs such as the colon,brain,and possibly the lung.CONCLUSION This case was characterized by the highest degree of malignancy and by multiorgan metastases,and it was the first case of intestinal GT uncovered by capsule endoscopy.

Glomus tumors of the fingers:Expression of vascular endothelial growth factor

Glomus tumors are uncommon,benign,small neuro-vascular neoplasms derived from glomus bodies in the reticular dermis. Glomus bodies are found throughout the body to regulate body temperature and skin circulation; however,they are concentrated in the fingers and the sole of the foot. The typical presentation is a solitary nodule in the subungual or periungual area of the distal phalanx. The primary treatment of choice is surgical removal. We investigated expression of vascular endothelial growth factor(VEGF) using immunohistochemistry in glomus tumors of the fingers. All five glomus tumor samples were positive for VEGF expression. VEGF immunoreactivity was largely localized to the cytoplasm of tumor cells,suggesting a contribution of VEGF to the vascularization of glomus tumors.

Combined laparoscopic-endoscopic approach for gastric glomus tumor:A case report

BACKGROUND Gastric glomus tumor(GGT)is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection.This paper presents a case of a GGT,exhibited both intraluminally and extraluminally growth that was removed by laparoscopy-gastroscopy cooperative surgery.CASE SUMMARY A 52-year-old male presented with epigastric discomfort accompanied by a sense of fullness for 3 mo.Upper gastrointestinal endoscopy identified a submucosal lump located in the gastric antrum.Endoscopic ultrasonography identified a 2.4 cm×1.8 cm lump located in the gastric antrum.It originated from the muscularis propria and exhibited both intraluminally and extraluminally growth,with hypoechoicity on the periphery,hyperechoicity in the middle,and unclear boundaries.Computed tomography showed nodular thickening of 3.0 cm×2.2 cm in the gastric wall of the gastric antrum,and after enhancement,the lesion exhibited obvious enhancement We suspected that it was a gastrointestinal stromal tumor(glomus tumor and schwannoma were not excluded)and planned to perform laparoscopy-gastroscopy cooperative surgery.Immunohistochemical staining after the operation revealed that spinal muscular atrophy(+),hcaldesmon(+),cluster of differentiation 34(CD34)(+),2%Ki-67-positive rate,CD56,melanoma antigen,CD117,discovered on GIST-1,leukocyte common antigen,caudal type homeobox 2,cytokeratin,and S-100 were all negative.The tumor was finally diagnosed as a GGT.CONCLUSION GGTs are rare submucosal tumors of the stomach and should be considered in the differential diagnosis of gastric submucosal tumors.Laparoscopy-gastroscopy cooperative surgery is less invasive and more precise and could be an effective method for the treatment of GGTs.

Bronchial glomus tumor with calcification: A case report

BACKGROUND Glomus tumors(GTs),defined by modified smooth cells and normal glomus body cells,usually present with a small mass occurring in the soft tissue or dermis of an extremity,especially in the subungual region.However,other unusual sites,such as the respiratory tract,have also been reported.They are usually sporadic.Their imaging findings are usually nonspecific and likely to appear as a well-delineated round mass that usually lacks calcification.To our knowledge,we report the first case of bronchial GTs with calcification,reminding clinicians and radiologists that GT is one of the differential diagnoses when a calcified nodular mass is found.CASE SUMMARY We report a case of a 33-yr-old Chinese man with cough and sputum for 11 d and hemoptysis for 5 d.Chest computed tomography revealed a calcified nodular lesion on the compressed posterior wall of the lower left main bronchus and bronchiectasis in the lower lobe of the left lung.To confirm the characteristics of calcified nodules,we performed fiberoptic bronchoscopy.The tumor tissue from the biopsy of bronchial mucosal lesions established the diagnosis of GT.Because the patient had no life-threatening symptoms,he was not treated with surgery.Clinical follow-up for 25 mo showed that the patient survived well without any discomfort.CONCLUSION Bronchial GTs are usually not accompanied by calcification on computed tomography scans.To our knowledge,we report the first calcified bronchial GT.We recommend that clinicians consider GT as a possible differential diagnosis when a calcified mass of the bronchi is found.

Endoscopic ultrasonography diagnosis of gastric glomus tumors

BACKGROUND A gastric glomus tumor is relatively rare,and there is little knowledge on its endoscopic ultrasound findings.AIM To assess the accuracy of endoscopic ultrasonography(EUS)in the diagnosis of gastric glomus tumor and to discuss its value by reviewing the literature.METHODS A retrospective analysis of the EUS characteristics of gastric glomus tumor(such as tumor location,shape,size,echogenicity,homogeneity,margins,layer of origin,and so on)was performed.The study included 12 cases of gastric glomus tumor confirmed by surgery and pathology(7 females and 5 males,age range 36-74 years,average age was 58.2 years).RESULTS All the lesions were located in the gastric antrum(12 cases),protruding into the cavity,with a diameter between 1 and 3.5 cm.Glomus tumor of the stomach manifested as a circumscribed and slightly hypoechoic mass in the fourth layer,with an internal heterogeneous echo mixed with hyperechogenic spots and a marginal more hypoechoic halo.Smooth muscle actin,h-caldesmon and vimentin were shown to be positive by immunohistochemistry.CONCLUSION Although glomus tumor of the stomach is relatively rare,a typical glomus tumor of the stomach has characteristic changes under EUS.

Glomus Tumor of the Kidney: A Case Report with CT, MRI, and Histopathological Findings

We describe the computed tomographic (CT) and magnetic resonance imaging (MRI) features of a very rare renal neoplasm, a glomus tumor. Our patient was a 68-year-old woman with a history of high grade T1 stage bladder cancer, status post intravesical Bacillus Calmette-Guérin (BCG) therapy and left ureteral stent placement, who presented for routine follow-up imaging evaluation of the urothelial tract. Computed tomographic urography (CTU) incidentally demonstrated a 1.7 cm well-circumscribed, non-calcified, non-fat containing lesion in the left renal cortex with arterial phase continuous peripheral rim enhancement and central hypoattenuation relative to enhanced renal parenchyma. Subsequent MRI showed the lesion to be isointense in signal intensity relative to the renal parenchyma on T1-weighted imaging and hyperintense on T2-weighted imaging. No macroscopic fat or microscopic lipid was seen within the lesion, and there were no foci of susceptibility artifact on T1-weighted images. Diffusion-weighted and apparent diffusion coefficient images demonstrated no restricted diffusion. Contrast-enhanced images demonstrated continuous peripheral rim enhancement in the arterial phase and persistent rim enhancement with partial centripetal fill in of enhancement on venous phase images, similar to the pattern seen on CT. Partial left nephrectomy was performed for the suspected solid renal neoplasm. Histopathological assessment was diagnostic of a renal glomus tumor.

Unusual glomus tumor of the lower leg: A case report

BACKGROUND Glomus tumors are rare neoplasms,usually found on the fingers or toes.Glomus tumours that occur in the lower leg are even rarer and is likely to be misdiagnosed or underdiagnosed.This article will document the diagnosis,treatment,and follow-up of a rare glomus tumor of the lower leg,which had been misdiagnosed for up to 15 years.CASE SUMMARY The patient was a A 36-year-old woman who had suffered from localized pain in her left lower leg for 15 years.After a complete physical examination,a glomus tumor on her lower leg was considered and removed surgically.The specimen was pathologically diagnosed as a glomus tumor.There was no relapse at a 4-year follow-up.CONCLUSION Correct diagnosis and complete removal of the glomus tumor is important.

Atypical glomus tumor of the body of stomach: a case report and review of literature

Objective: The aim of this study was to analyze the clinical pathological features of the atypical glomus tumor of the stomach, and explore its biological behavior and clinical significance. Methods: a 43-year-old female was admitted due to passing black stool for 5 months. The melena of the patient occurred after eating the crabs. The endoscopic ultrasonography (EUS) was performed, showing a hypoecho nodule found at the body of the stomach, suggesting the diagnosis of gastric stromal tumor. After onset of disease, no specific clinical symptoms were observed except for the slight feeling discomfort in upper abdominal region. The gastroscopy was performed under the general anesthesia: there was a spheroidal nodule measuring 2.5 cm x 3.0 cm at the anterior wall of the body of stomach near the side of lesser curvature with the focal erosion of gastric mucosa. The DualknifeTM and the snare were used to excise the tumor in full thickness. Grossly, the tumor nodule measured 2.5 cm in diameter. The cut surface was solid, showing moderate consistency and grey red in colour. Microscopically, this tumor presented a well circumscribed nodule. It composed of the rounded neoplastic cells which were mainly arranged in solid pattern. The tumor cells had well-defined cell membranes, centrally placed, round nuclei and amphophilic cytoplasm. Immunohistochemical staining showed the positive expression of smooth muscle actin (SMA), caldesmon and vimentin; meanwhile detecting the negative expression of desmin, pan-cytokeratin, CD34, CD117 and S-100 in tumor cells. The Ki-67 labelling index of tumor was 8%. Results: Combined with the histopathological features, immunophenotype of the tumor, deep location in abdominal cavity and with greater diameter larger than 2 cm, and the diagnosis of atypical glomus tumor of the body of the stomach in this case was established. Conclusion: The atypical glomus tumor of the body of the stomach is a rare mesenchymal tumor. The following differential diagnosis should be included as following: gastrointestinal stromal tumor (GIST), paraganglioma, myopericytoma and the angioleiomyoma. The immunohistochemistry exerts an essential role during the diagnosis of this tumor. The deeper location and larger size implicate its undetermined biological behavior.

GLOMUS TUMORS──A REVIEW OF 8 CASES WITH INTRODUCTION OF A MODIFIED COMBINED INTRA-AND EXTRACRANIAL APPROACH

Eight cases of glomus tumors hospitalized in our department from 1982 through 1995 were reviewed. It comprised of five glomus tympanic tumors and three glomus jugular tumors. Discussion was centered on it's contemporary diagnosis, classification and surgical treatment with introduction of a modified combined intra-and extracranial surgical approach to resect the extensive glomus tumors.

The microsurgical treatment of glomus tumor at the nail bed of the finger

Objective： To discuss the diagnosis and treatment of glomus tumor at the nail bed of the finger. Methods： The course and therapeutic outcome of 12 cases of glomus tumor which were resected and confirmed by histology examination were analyzed. Results：All cases were followed up for six months up to 2 years, no recurrences were observed, the shape of the nait was normal. Conclusion： Microsurgical treatment of glomus tumors of the nail bed is effective.

Glomus tumor of the gastric body:helical CT findings

Glomus tumors, also known as glomangiomas, are rare and originate in the neuromyoarterial glomus, a normal arteriovenous shunt which is abundantly supplied with nerve fibers and fulfills a temperature-regulating function. The classic location of glomus tumor is the subungual region, but the tumor can occur elsewhere in the skin, soft tissues, nerves, stomach, nasal cavity, and trachea.In the gastrointestinal （GI） tract the tumor occurs more often in the stomach than other parts, and typically occurs as a solitary submucosal nodule in the antrum. We reported a case of glomus tumor originating from the greater curvature of stomach which was studied with contrast-enhanced helical computed tomography （CT） and described the characteristic helical CT findings of the rare lesion.

Tracheal glomus tumor： two cases with bronchoscopic intervention

Glomus tumors are neoplasms derived from specialized cells of glomus bodies surrounding arteriovenous anastomoses.Although most of them are benign,aggressive cases have been described.Glomus tumors can be found throughout the body but are most highly concentrated in the digits,palms,and soles of the feet.It is rare in lung and trachea and the optimal therapy has not been thoroughly described.

Multiple glomus tumor on the anteromedial side of leg

To the editor, Multiple glomus tumor is a rare benign neoplasmthat arises from the glomus body in the stratum retic-ularis of the dennis, the highly specialized arteriove-nous anastomosis for thennoregulation.1-4 Althoughseveral cases of multiple glomus tumor involving theanterior thigh,5 submandibular and parotid regions,6 thetorso,7 have been reported, radiological characteristicson MRI images for multiple glomus tumor have notbeen described.We reported here both pre-operativeand post-operative MR images from a case of 16years old girl with multiple glomus tumor that partiallycoalesced on the anterior side of the leg.

Recurrent glomangioma("true"glomus tumor)of the middle ear and mastoid

Objective:To review current literature and experience with glomangiomas,or true glomus tumors of the middle ear and mastoid as well asto report on the exceptionally rare case of a glomangiomastemming from the middle ear space with multiple recurrences.Methods:Review of existing world literature and description of personal experience with rare cases of a glomangioma of the middle ear and mastoid.Results:Review of existing literature revealed two cases of patients presenting with tinnitus and hearing loss refractory to medical management.Both patients were ultimately diagnosed with glomangioma on histopathology.Complete surgical excision is thought to be curative.Patient:A 36-year-old woman presented with a rare case of a glomangioma of the middle ear presenting with unilateral hearing loss.She was noted to have a mass behind the tympanic membrane.Imaging revealed a diffuse mass filling the mastoid air cells.Imaging characteristics and histology were consistent with a glomangioma.Intervention:Initial resection via mastoidectomy using a postauricular approach.The tympanic membrane was reconstructed with temporalis tissue.Follow-up revision tympanomas-toidectomy was performed upon recurrence of disease.The chorda tympani were sacrificed due to tumor involvement.The incus and head of the malleus were removed to gain better access to the tumor.The ossicular chain was reconstructed with a Goldenberg Total Ossicular Prosthesis.Main outcome measure:Recurrence of disease.Follow-up:In the 67 months since her most recent surgery,there has been no evidence of recurrence by CT or physical exam.Conclusion:Glomangioma of the middle ear represents an exceptionally rare entity that can present in a similar fashion to a paraganglioma.

Unusual gastric tumors and tumor-like lesions: Radiological with pathological correlation and literature review

Although gastric tumors have overlapping radiologic appearances, some unusual tumors may present specific imaging features. Using multidetector computed tomography(MDCT), with water as a negative oral contrast agent and intravenous contrast medium, can provide critical information for the diagnosis of gastric diseases. In addition, MDCT can evaluate the involvement of the gastric wall and extragastric extent of the disease, as compared with gastroenteroscopy and double-contrast upper gastrointestinal study. Regarding lesion location and size, enhancing and growth patterns, presence of calcification or fat, and involvement of the gastric wall and adjacent structures, CT may provide useful information. In this review article, we review the relevant literature and discuss the CT features and the histopathologic findings of different types of gastric lesions. The lesions are divided into benign(glomus tumors, schwannomas, leiomyomas, and lipomas), malignant(gastrointestinal stromal tumors, mucinous carcinomas, lymphomas, and carcinoid tumors), and tumor-like lesions(ectopic pancreas and bezoar). Familiarity with imaging appearances and pathologic findings can help physicians make an accurate diagnosis.

Glomangiomatosis-immunohistochemical study:A case report

BACKGROUND Glomangiomatosis(also known as diffuse glomus tumor)is extremely rare,accounting for only 5%of glomus tumors.The prevalence of glomus tumors is only 2%of soft tissue tumors.Lesions can recur after resection.Although growth may be diffuse or infiltrating and invasive,definitive identifying standards for malignant glomus tumors are lacking.This article describes a case of glomangiomatosis with many nodular masses in the soft tissues of the right foot and calf.A review of the Chinese and English-language literature is included.CASE SUMMARY A case of glomangiomatosis in a 55-year-old Chinese woman who presented clinically with many nodular masses in the soft tissues of the right foot and calf.The tumor was examined histologically and immunostaining was performed.CONCLUSION Glomangiomatosis occurs most often in young people,in the distal extremities,but is rare.Multiple nodules are even rarer.Only 15 clinicopathological analyses of glomangiomatosis have been reported in the combined Chinese-and Englishlanguage literature.In the present case,microscopically,nested vascular globular cells were observed around the blood vessel wall.Immunohistochemistry revealed diffuse immunoreactivity for smooth muscle actin,vimentin,type Ⅳ collagen,and Bcl-2.Caldesmon,CD34,and calponin were weakly,partially,and slightly positive,respectively.There was no recurrence 1 year after resection.

Glomus tympanicum removal using transcanal endoscopic assisted surgery:An experience with six cases

Objective:To evaluate an endoscopic approach in the management of glomus tumor,and also to investigate and evaluate its appropriateness and feasibility.Methods:Glomus tumors,also known as paragangliomas,are benign primary tumors of the middle ear.The advent of endoscopic ear surgery has provided new dimensions to the management of this highly vascular tumor.Retrospective analysis of six patients of glomus tympanicum,operated between July 2014 and June 2019,with modified Fisch classification Type A and B1,who were managed by a retroauricular transcanal endoscopic approach.Preoperative and postoperative analysis was done for these patients.Results:The chief complaint was pulsatile tinnitus,which disappeared in five cases and reduced in severity in one of them.Hearing was improved with reduction in air‐bone gap in all the cases.No major complications or recurrence were observed in any of the patients after 12 months of follow‐up.Conclusion:This endoscopic approach serves as a safe and reliable technique for tumor removal.It thus provides postoperative comfort for most of the patients.