Endoscopic-Guided Therapy for Tracheal Glomus Tumor: A Case Report on Radiofrequency Plasma-Assisted Therapy.

This is a case report on the treatment of tracheal glomus tumor, which is a rare tumor originating from the glomus bodies in the trachea and form spherical or nodular masses. These tumors can lead to obstruction and narrowing of the tracheal lumen, causing symptoms such as dyspnea. The standard treatment for tracheal glomus tumors is typically surgical resection. In this case, the patient underwent a procedure involving low tracheostomy with closure of the airway and mechanical ventilation through the stoma, followed by endoscopic-assisted subglottic tracheal glomus tumor resection using plasma-assisted radiofrequency.

A rare case of extra-digital glomus tumor of the thigh.

INTRODUCTION: Glomus tumors are rare benign tumors arising from glomus bodies that are responsible for thermoregulatory control. Their typical location is the subungual area of the digits, and extra-digital glomus tumors are very rare, leading to misdiagnosis and delayed treatment due to the absence of typical symptoms. CASE: Here, we report the case of a 49 years old male patient with a long history of localized right thigh pain who was found to have an extra-digital glomus tumor of the thigh after surgical excision. DISCUSSION: A comprehensive physical examination, detailed medical history, in depth imaging and early surgical excision upon clinical suspicion may prevent delayed or incorrect diagnosis. The treatment of glomus tumor is surgical excision providing immediate relief from pain, however if the lesion is not palpable, it can be easily missed or confusing with other diagnoses such as schwannoma, neuroma or arteriovenous malformation. CONCLUSION: Glomus tumors of the thigh represent an exceptional location for extra digital glomus tumors. The aim of this report was to make the surgical community more aware of this entity to prevent delayed treatment and misdiagnosis. Glomus tumor should be kept in mind in the differential diagnosis of all painful subcutaneous lesions.

Renal glomus tumor: A case report and literature review.

Glomus tumors are rare mesenchymal tumors involving cells from the glomus body, smooth muscle, and vasculature, typically found in distal extremities' skin. This case describes a 54-year-old woman with a history of hypothyroidism and hyperlipidemia, incidentally discovered to have a four-centimeter calcified renal tumor. Surgery was performed due to suspected malignancy. Immunohistochemical staining confirmed a renal glomus tumor, positive for muscle actin and smooth muscle actin (SMA). The tumor was benign, and no adjuvant therapy was needed. The patient remained recurrence-free during follow-up. Renal glomus tumors are predominantly benign, with surgical resection as the primary treatment.

Rapidly progressive malignant glomus tumor of the breast: a case report and review of the literature.

The glomus tumor is a rare neoplasm that is typically found subungually in the extremities and functions as a specialized neurovascular organ. An extremely rare site for glomus tumors is the breast, with only a few reported cases. Breast glomus tumors present with three typical clinical signs: dull pain, focal tenderness, and cold sensitivity. Less than 10% of all glomus tumors are malignant. We herein present a case of a malignant glomus tumor originating in the breast. Distant metastasis was ruled out, and the tumor was completely resected. However, the patient unexpectedly developed rapid systemic metastasis, detected 5 weeks after tumor removal. Despite the administration of analgesics and targeted therapy, the patient died 1 month later. When treating patients with undiagnosed breast tumors, clinicians should pay attention to unexplained and repeatedly reported symptoms and consider the possibility of a rare disease. Our literature search revealed no cases of malignant glomus tumors originating in the breast, making this case the first of its kind.

Surgical Management of Difficult Nail Glomus Tumors.

Background: Nail glomus tumor is a well-known tumor, with well-defined clinical characteristics and surgical treatment; however, some of these lesions occur in different locations and sizes with difficult surgical resolution. Summary: Clinical and imaging tests help in the diagnosis and tumor localization. Key Message: Adequate surgical knowledge for these cases ensures lower rates of recurrence and nail dystrophy.

Endoscopy-assisted laparoscopic wedge-resection of gastric glomus tumor: A case report.

INTRODUCTION: Glomus tumor is a pericytic mesenchymal neoplasm that most commonly occurs in the extremities. The occurrence in visceral organs is rare and is a differential diagnosis with other gastric submucosal tumors. PRESENTATION OF CASE: A woman with epigastric pain underwent esophagogastroduodenoscopy (EGD) which revealed a gastric submucosal tumor. Endoscopic ultrasound with fine-needle aspiration allowed preoperative diagnosis of gastric glomus tumor. Intraoperative EGD-assisted laparoscopic segmental gastrectomy was successfully performed. The patient was discharged in the second postoperative day. There was no evidence of recurrence at 8 months of follow-up. DISCUSSION: The stomach is a rare location for the glomus tumor, a neoplasm of the glomus body, which is a perivascular structure with thermoregulatory function. Preoperative diagnosis is challenging, and endoscopic ultrasound (EUS) is useful for both assessing malignancy-associated features and biopsy guiding. The treatment is surgical resection with attention to adequate oncological margins while preserving healthy gastric wall. CONCLUSION: Immunohistochemical analysis of specimen obtained by EUS fine-needle allows accurate preoperative diagnosis and laparoscopic-endoscopic combined surgery allows good oncological and functional results.

Glomus tumor with malignant features: A case report and review of the literature.

Glomus tumors are rare mesenchymal neoplasms of the subcutaneous tissue, most frequently found in the distal extremities. They are typically benign, but malignant glomus tumors have been described in the literature. Here we present a patient found to have a unilateral renal mass with pathology displaying a primary renal glomus tumor with malignant features. Review of the literature reveals only three cases of malignant glomus tumors and five glomus tumors with malignant potential. As such, previous initial presentations, current criteria for glomus tumor malignancy, and previous treatment outcomes of these cases were reviewed.

A rare primary sacral glomus tumor presenting as intradural-extramedullary tumor: A Case report and review of literature.

Background: Glomus tumors are very infrequent in the spine where they can grow intraosseously at any level. We were able to identify only eight such cases in the literature, with only one occurring in the sacrum. Here, a 48-year-old male with sacral S1/S2 radiculopathy was found to have a rare glomangioma/glomus tumor of the sacral region. Case Description: A 48-year-old male presented with left-sided S2 radiculopathy characterized by left lower extremity weakness/paresis. The magnetic resonance showed an intradural extramedullary mass measuring 1.8 × 1.9 × 4.3 cm at S1-S2 extending through the left foramen, inhomogeneously enhanced with contrast. He underwent an S1-S2 durotomy with gross total excision of the mass. Pathologically, it proved to be a glomus tumor. Two months postoperatively, he ambulated without the support and demonstrated no tumor recurrence at 1 postoperative year. Conclusion: Glomus tumors involving the sacral region are rare and can be successfully excised resulting in good clinical outcomes.

Glomus Tumor of the Left Second Toe Distal Phalanx: A Case Report and Review of Literature.

Introduction: Glomus tumors are rare, benign neoplasms that originate from glomus bodies. While usually occurring in the subungual regions of the fingers, glomus tumors are seldom found in the foot, although rare reports have been made of glomus tumors in the hallux and even fewer in the lesser toes. We describe a reported case of a glomus tumor occurring in the distal phalanx of the left second toe that was initially missed on imaging studies, resulting in delayed diagnosis and surgical treatment. To the best of our knowledge, this represents one of the first few cases of glomus tumor reported in the lesser toes. Case Report: A 34-year-old Chinese female presented with pain in the left second toe occurring for several years. Initial assessment and radiological investigations came back negative for abnormalities, resulting in delayed treatment. Upon second opinion of the MRI scans, a 0.2 × 0.2 × 0.2 cm well-defined round enhancing high T2-weighted signal focus within the germinal matrix of the left second toe subungual region was found, suggestive of a glomus tumor. Surgical exploration was offered, which found a skin-colored lesion, which was resected using a transungual approach. The final histology of the excised mass showed perivascular proliferation of uniform cells which contained round to ovoid nucleus with small nucleolus and pale eosinophilic cytoplasm, confirming glomus tumor. Conclusion: Glomus tumors are rarely found in the foot, with even fewer reports in the lesser toes. Their rare occurrence in these regions reduces diagnostic suspicion for these tumors, delaying diagnosis and treatment for patients. This case report highlights the difficulty in diagnosing glomus tumors, even with adequate radiological investigations, and showcases the need for careful scrutinization of imaging. As this presentation is extremely uncommon, we hope that this case report increases suspicion of glomus tumors as a differential diagnosis for toe pain to ensure early treatment and alleviation of symptoms for patients.

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

OBJECTIVE: 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). MATERIALS AND METHODS: 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). RESULTS: 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. CONCLUSION: 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.

Facial nerve palsy after ethylene vinyl alcohol arterial embolization of glomus tympanicum.

BACKGROUND & OBJECTIVE: Glomus tympanicum and jugulare tumors are highly vascular and are therefore commonly embolized before surgical resection to prevent intra-operative bleeding. We report a case of facial nerve paralysis after pre-operative embolization for a glomus tympanicum tumor with ethylene vinyl alcohol (EVOH also known as Onyx) embolic agent. We discuss the choice of embolic agent in relation to the risk of this complication and potential management strategies. METHODS: A 57F with right glomus tympanicum developed right facial nerve palsy immediately after embolization. She received 24 mg of dexamethasone over the course of 24 h immediately following her embolization, surgical facial nerve decompression concurrent with tumor resection, and a 10-day prednisone taper. Our main outcome measure was facial nerve function on follow-up physical examinations. RESULTS: The patient developed right facial paralysis (HB 6/6) after Onyx embolization of branches of the external carotid artery system, likely due to translocation of embolic agent into facial nerve vasa nervosa as seen on post-embolization CT. No immediate improvement was observed with high dose steroids and decompression, however over the next 6 months her facial nerve function began to improve (HB 3/6). CONCLUSIONS: Surgical excision is the standard of care for glomus jugulare and glomus tympanicum tumors. Due to their propensity to bleed, their arterial feeders (branches of the external carotid) are often embolized prior to surgery, however, facial nerve paralysis is a rare but serious complication. There is a possible relationship between the choice of embolic agent and this complication. Though facial palsy is of sufficient rarity that no standard treatment pathway exists, due to the impact on a patient's quality of life, we recommend aggressive therapy to salvage nerve function.

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.

Challenges in the diagnosis and management of tumor-induced osteomalacia: A case report.

The present case report is aimed to highlight the difficulty and the reason for the delayed diagnosis of phosphaturic mesenchymal tumors, emphasizing the need of standardized protocols for diagnosis, surgery and follow-up in high-volume hospitals. The clinical signs and symptoms, diagnostic and therapeutic procedures, immunohistological features were analyzed. Delayed diagnosis of phosphaturic mesenchymal tumor was primarily due to non-specific clinical symptoms such as fatigue, muscular and bone pain, and multiple fractures. This cryptic clinical picture made the diagnosis tricky that led to treatment of patient for non-specific pain and stress fractures before to consider the tumor-induced osteomalacia syndrome. Some well-documented studies were found in the literature in which the history of trauma is a critical trigger of glomus tumors. Extra-subungual tumors most frequently occur in the knee and ankle regions, particularly among young adults, and the diagnosis is typically made approximately 7.2 years after initial symptom onset. The difficult tumor localization represented an additional obstacle to the prompt treatment, leading to delayed curative surgery.

Combined treatment for a rare malignant glomus tumor of the esophagus with pulmonary and liver metastases: a case report and review of literature.

Background: Glomus tumors are typically benign soft tissue tumors that occur at the extremities; malignant and viscerally occurring cases are extremely rare. Case presentation: We report a 49-year old male patient with a malignant esophageal glomus tumor that was complicated by lung and liver metastases. Genetic test results guided the patient's individualized treatment. Consequently, treatment with Anlotinib combined with Tislelizumab achieved significant clinical benefits. Conclusion: Our case report demonstrates that immunotherapy combined with anti-angiogenic therapy in patients with malignant esophageal glomus tumors can achieve significant efficacy and suggests the potential value of next-generation sequencing (NGS) detection in guiding personalized treatments in patients with malignant esophageal glomus tumors.

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.

Additional Role of 3D ASL Perfusion in Skull Base Lesions.

Background Arterial spin labeling (ASL) perfusion imaging is widely used since its main advantage is that no intravenous contrast is needed. Given that perfusion is a crucial biological characteristic for identifying tumor lesions, the qualitative noncontrast perfusion characteristics of these lesions were examined. Aim We attempted utilizing the three-dimensional (3D) ASL technique to characterize skull base lesions and to highlight its crucial role in differentiating lesions. Methods and Material 3D ASL imaging of 20 patients with posterior skull base lesions was performed in a 3-T magnetic resonance (MR) system (Siemens Healthineers, Skyra, Erlangen, Germany). The common differential diagnoses of skull base lesions could be distinguished based on this qualitative evaluation. Results and Conclusions Glomus tumor has a strikingly increased perfusion when compared to meningiomas. The perfusion characteristics of metastasis depends on the primary tumor. Chondrosarcomas have a heterogeneously increased perfusion. Chordomas have variable perfusion, which helps in prognosticating the tumors. ASL benefits pediatric patients and in renal failure as well since it avoids the ethical ambiguity associated with contrast agents.