Invasive glomus tumor of the nasal cavity

An Atypical Lesion in the Nasal Cavity: Glomus Tumor

Glomus tumors are rare vascular tumors that originate in the glomus bodies. These tumors are uncommon in the head and neck region and are extremely rare in the nasal cavity. Intranasal glomus tumors mostly have a clinical and radiologic indolent behavior. This report presents the clinical, pathological, and radiological features of a 60-year-old female patient with a glomus tumor that has an atypical size and location.

Ethmoid glomangioma and oncogenic osteomalacia: a case report

Background

Glomangioma is a benign tumor of mesenchymal origin, derived from the glomus body. It is responsible for the thermal regulation of the dermis. The occurrence of oncogenic osteomalacia related to glomangioma is rare. Only two cases have been reported thus far.

Case presentation

A 32-year-old female, Brazilian, presented diffuse pain, during pregnancy, that developed progressively, limiting her mobility. Imaging showed a femoral neck fracture, and rheumatological laboratory examination showed hypophosphatemia. Also, the patient reported episodes of epistaxis during childhood and recurrence along with progressively right nasal obstruction. Endoscopic resection of the tumor was performed, and immunohistochemistry was conclusive for glomangioma. This case report describes the third case in which endonasal endoscopic surgery resulted in a favorable outcome.

Conclusion

This case of glomangioma-induced oncogenic osteomalacia suggests that surgeons and clinicians should consider sinonasal tumors as a differential diagnosis of osteomalacia, and endonasal endoscopic surgery should be a possible curative resection.

Lobular capillary hemangiomas: Case report and review of literature of vascular lesions of the nasal cavity

Vascular tumors of the nasal cavity can represent a variety of pathologies. In this case report, we discuss two patients presenting with a large vascular lesion occupying the nasal cavity. Significant bleeding was encountered during the initial attempts for endoscopic surgical resection. One lesion was successfully excised following preoperative embolization while a second following sphenopalatine artery vascular ligation. In both cases, final pathology showed lobular capillary hemangioma (LCH). We present a literature review and discussion of LCH and other vascular tumors that present in the nasal cavity. In addition, we discuss the utility of pre-resection vascular control of these tumors.

Soft tissue tumors of the head and neck: imaging-based review of the WHO classification

The World Health Organization (WHO) system for defining and classifying soft tissue tumors is usually applied to lesions that occur in the trunk and extremities, but it also provides an excellent framework for characterizing nonepithelial extraskeletal tumors of the head and neck. Although nonepithelial extraskeletal tumors are in the minority among head and neck lesions, they are by no means rare. The WHO classification system recognizes nine major types based on histologic differentiation: adipocytic, fibroblastic or myofibroblastic, fibrohistiocytic, smooth muscle, skeletal muscle, vascular, pericytic, and chondro-osseous tumors, as well as soft tissue tumors of uncertain differentiation. Tumors of each histologic type may be further subclassified on the basis of their biologic behavior as benign, intermediate (ie, having malignant potential), or malignant. Imaging plays an important role in the noninvasive diagnosis and characterization of nonepithelial soft tissue tumors of the head and neck, providing clues about tumor grade, composition, extent, and involvement of adjacent structures. Although the imaging characteristics of many such tumors are nonspecific, consideration of the clinical history in concert with the imaging findings may help limit the differential diagnosis or even allow reliable diagnosis of some of these tumors.

CD34-positive expression in benign nasal glomus tumour: two case reports and a literature review

Nasal glomus tumours are extremely rare neoplasms with poorly understood histogenesis, but which are clinically recognized as benign. The neoplastic cells of glomus tumours resemble normal glomus cells and are arranged around a varying number of thin-walled, sometimes branching, capillaries. CD34 is known to be a marker of tumour progenitor cells. In this report, two cases of benign nasal glomus tumour are presented. The tumours were excised completely via endoscopic endonasal surgery under local anaesthesia. During surgery, there was little bleeding and the post-surgical course for both patients was uneventful. Tumour cells from both cases were positive for α-smooth muscle actin, actin, vimentin and CD34 protein. Thus, CD34 positivity against a background of other immunohisto chemical markers is helpful in the differential diagnosis of glomus tumours.

Intraorbital and intracranial soft-tissue glomus tumor in an 8-year-old child. Case report

Soft-tissue glomus tumors (or glomangiomas) are unrelated to neuroendocrine paragangliomas (glomus tympanicum, jugulare, and vagale). The authors present the first reported case of an orbital soft-tissue glomus tumor in a child. An 8-year-old girl developed rapidly progressive right-eye blindness, proptosis, and a sixth cranial nerve palsy. Magnetic resonance imaging demonstrated a homogeneously enhancing lesion extending from the right orbit through the superior orbital fissure to the cavernous sinus and middle cranial fossa. A biopsy specimen demonstrated the lesion to be a soft-tissue glomus tumor. Following angiography and embolization, a gross-total resection of the tumor was achieved. The patient was treated with adjuvant proton-beam radiotherapy. At 24 months follow-up her proptosis and sixth cranial nerve palsy had resolved and there was no evidence of tumor recurrence.