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.

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.

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.

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.

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.

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.

Clinicopathological features of gastric glomus tumor

AIM:To study the clinicopathological features of gastric glomus tumor and review the related Chinese literature published in 1990-2010.METHODS:A case of gastric glomus tumor was re-ported.Clinicopathological findings in 56 cases of gastric glomus tumor were analyzed.RESULTS:Gastric glomus tumor was far more common in women than in men with a female to male ratio of 1.6:1.The median age of the patients was 45 years(range 28-79 years).The patients often complained of epigastric pain and bloody stool.The tumor was located in antrum of the stomach.The greatest diameter of the tumor was 0.8-11cm.Histologically,the tumor was comprised of nests of glomus cells surrounding the capillaries.Glomus cells were small,uniform and round.Vimentin,smooth muscle actin and actin were expressed in the tumor.Other markers,including S-100 protein,CD34,CD117,desmin,CD56,synaptophysin,chromo-granin A,neuron specific enolase and cytokeratin were all negative.CONCLUSION:Gastric glomus tumor is a rare benign mesenchymal neoplasm.Its diagnosis depends on pathologic examination.Differential diagnosis includes gastrointestinal stromal tumor,paraganglioma and carcinoid tumor.

Glomus tumor in the stomach:Computed tomography and endoscopic ultrasound findings

A 57-year-old man presented with intermittent dull abdominal pain after a period of 1 year.Abdominal computed tomography(CT) was performed.Except for the endoscopy,the work-up for possible medical causes remained inconclusive.An open-abdomen,partial surgical excision of the stomach was performed after the unsuccessful endoscopic resection.The pathology report revealed a glomus tumor of the stomach.Importantly,glomus tumors of the stomach are rare and are almost always benign.Therefore,the most important current role of imaging associated with the diagnostic approach and therapeutic plan for a glomus tumor is to differentiate it from other gastric submucosal tumors(SMTs).We report this case with representative radiologic findings,including CT and endoscopic ultrasound(EUS) reports,and also correlate them with clinical and pathologic presentations that can help in the early detection and differentiation of gastric SMTs from other SMTs.As such,the purpose of this report is to provide a better understanding of relevant CT and EUS features.Alternative treatments should be considered carefully according to the imaging results.

Diagnostic utility of endoscopic ultrasound-guided fineneedle aspiration biopsy for glomus tumor of the stomach

A 52-year-old man was referred for further investigation of a gastric submucosal tumor on the greater curvature of the antrum. Endoscopic ultrasonography demonstrated a hypoechoic solid mass, which was primarily connected to the muscular layer of the stomach. We performed endoscopic ultrasoundguided fine-needle aspiration biopsy. The pathological examination showed proliferation of oval-shaped cells with nest formation, which stained strongly positive for muscle actin, and negative for c-kit, CD34, CD56,desmin, S-100, chromogranin, and neuron-specific enolase. Therefore, we performed laparoscopy and endoscopy cooperative surgery based on the preoperative diagnosis of glomus tumor of the stomach. The final histological diagnosis confirmed the preoperative diagnosis. Although preoperative diagnosis of glomus tumor of the stomach is difficult with conventional images and endoscopic biopsy, endoscopic ultrasoundguided fine-needle aspiration biopsy is an essential tool to gain histological evidence of glomus tumor of the stomach for early diagnosis.

Glomus tumor of uncertain malignant potential of the brachial plexus: A case report

BACKGROUND Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusual features can be occasionally found, leading to distinctive malignant potential required different therapeutic approaches. Glomus tumor of uncertain malignant potential is one type of atypical glomus tumor with limited criteria for malignancy and without metastasis. CASE SUMMARY Herein, we report a case of a 48-year-old Thai male with a large painful mass in his axilla for one year without apparent neurological deficit. Magnetic resonance imaging showed a large heterogeneous mass encasing entire posterior cord of left brachial plexus and axillary artery. The tumor tissue from core needle biopsy histologically demonstrated the sheets and cords of relatively uniform tumor cells with foamy cytoplasm and round to oval hyperchromatic nuclei without atypia. The mitotic count was 0 per 50 high power field. A final diagnosis of glomus tumor of uncertain malignant potential was rendered. Complete surgical resection was performed, followed by adjuvant radiation due to positive margin. Neither local recurrence nor distant metastasis was observed at 2-year follow up. Unfortunately, postoperative incomplete brachial plexopathy without signs of reinnervation by electromyography was persisted. Later nerve grafting reconstruction was performed, followed by ongoing neurological rehabilitation. CONCLUSION Glomus tumor of uncertain malignant potential is exceedingly rare, especially around brachial plexus. Although the prognosis is good, careful histological diagnosis and treatment are needed to achieve an optimal outcome with lower morbidity.

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.

Glomus Tumors of the Lung: Diagnostic Considerations and Treatment

Glomus tumors derive from the glomus cell around arteriovenous anastomosis. These are rare tumors and when found are most common in the deep dermis of the extremities. In rarer cases still they have been reported to be found in the lung. These are most commonly incidental findings of solitary lesions of the lung with a pre-operative differential diagnosis of non-small cell carcinomas and carcinoids. Due to the rare nature of these tumors, they are rarely considered in the differential diagnosis and are also often misdiagnosed at the time of frozen section. We present three cases of glomus tumors of the lung with emphasis on the consideration of the method of diagnosis, histological findings and management.

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 nail 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.

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.

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.

单孔腹腔镜联合内镜治疗胃血管球1例及国内外文献复习

分析川北医学院附属医院胃肠外科2023年4月收治的1例罕见疾病[胃血管球瘤(GGT)]患者。该例患者术前临床诊断为胃间质瘤,术后通过免疫组织化学确诊为GGT,经单孔腹腔镜联合内镜治疗后痊愈出院。GGT术前难以确诊,且易误诊为胃间质瘤,手术切除肿瘤是其唯一治疗方法。该文深入探讨GGT的临床表现、影像及病理特征、临床诊断、鉴别诊断及治疗方法,并复习国内外相关文献,以便为今后临床工作提供参考信息。

指腹球血管肌瘤1例

血管球瘤是起源于正常血管球的少见良性肿瘤,好发于肢体远端,在软组织肿瘤中占比不足2%。血管球瘤在组织病理学上分为固有球瘤、球血管瘤和球血管肌瘤3种亚型,其中球血管肌瘤的亚型最为少见,国内报道仅见6例。本文报道1例发生于指腹的球血管肌瘤,患者,女,50岁,因“手指肿物”于2023年6月在海南省人民医院进行手术治疗,术后病理确诊为球血管肌瘤。球血管肌瘤主要由圆形和梭形的肿瘤细胞构成,梭形的肿瘤细胞与圆形的肿瘤细胞之间存在过渡。肿瘤细胞围绕血管壁生长,间质可黏液样变。据笔者所知,这是首例发生于指腹的球血管肌瘤。