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Sanders P, Spouge RJ, Akbari M, Spouge DJ. Ethanol ablation of extradigital solid glomus tumors. Skeletal Radiol 2014; 43:1755-9. [PMID: 25022808 DOI: 10.1007/s00256-014-1956-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2014] [Revised: 06/12/2014] [Accepted: 06/26/2014] [Indexed: 02/02/2023]
Abstract
Glomus tumors are predominantly benign neoplasms accounting for less than 2% of all soft tissue tumors. While generally solitary, multiple lesions have been reported in approximately 10% of cases. Glomus tumors are typically under 1 cm in dimension accompanied by the classic triad of symptoms: debilitating pain, pinpoint tenderness, and hypersensitivity to cold temperatures. Excisional therapy is the accepted standard of care, however, past reports of non-invasive treatments for multiple glomangiomata variant tumors include laser therapy, irradiation, and sclerotherapy with STS and hypertonic saline. We present a case of a patient with multiple subcutaneous and intramuscular, lower-extremity benign solid glomus tumors treated successfully utilizing ethanol ablation, which has not been previously reported. This minimally invasive treatment allowed for control of symptoms from a benign condition previously requiring multiple invasive surgeries.
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Affiliation(s)
- Paul Sanders
- Department of Radiology, Queen's University, Kingston, Ontario, Canada
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3
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BHUSHAN M, KUMAR S, GRIFFITHS C. Multiple glomus tumours, Coats' disease and basic fibroblast growth factor. Br J Dermatol 2008. [DOI: 10.1046/j.1365-2133.1997.18691938.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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4
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Gholve PA, Hosalkar HS, Finstein JL, Lackman RD, Fox EJ. Popliteal mass with knee pain in a 57-year-old woman. Clin Orthop Relat Res 2007; 457:253-9. [PMID: 17119460 DOI: 10.1097/blo.0b013e31802ce049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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5
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Lu R, Krathen RA, Sanchez RL, May NC, Hsu S. Multiple glomangiomas: Potential for confusion with blue rubber bleb nevus syndrome. J Am Acad Dermatol 2005; 52:731-2. [PMID: 15793549 DOI: 10.1016/j.jaad.2004.12.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Tuncali D, Yilmaz AC, Terzioglu A, Aslan G. Multiple occurrences of different histologic types of the glomus tumor. J Hand Surg Am 2005; 30:161-4. [PMID: 15680574 DOI: 10.1016/j.jhsa.2004.09.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2004] [Accepted: 09/21/2004] [Indexed: 02/02/2023]
Abstract
A patient with 3 glomus tumors that occurred at different locations and times is presented. Two of the 3 tumors were of the same histologic type. The third tumor was a different type. Although it is rare, a solitary type of glomus tumor on initial presentation may exhibit multiple occurrences in the same patient.
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Affiliation(s)
- Dogan Tuncali
- Department of Plastic Reconstructive and Aesthetic Surgery, Ankara Education and Research Hospital, Cebeci, 06700 Ankara, Turkey
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Abstract
Increased understanding of the mechanisms of angiogenesis and lymphangiogenesis has provided a glimpse at some of the molecules involved in the pathophysiology of hemangiomas and vascular malformations. This review focuses on recent advances in our understanding of the mechanisms of angiogenesis/lymphangiogenesis and the differentiation of arterial, venous, and lymphatic vessels. We integrate this knowledge with new data obtained from genetic studies in humans, which have revealed a number of heretofore-unsuspected candidates involved in the development of familial vascular anomalies. We present a common infantile vascular tumor, hemangioma, and then focus on hereditary familial vascular and lymphatic malformations. We also summarize transgenic mouse models for some of these malformations. It seems reasonable to believe that novel therapeutic strategies will soon emerge for the treatment of hemangiomas and vascular malformations.
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Affiliation(s)
- J-C Tille
- Department of Clinical Pathology, University Medical Center, Geneva, Switzerland
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Abstract
Vascular anomalies are localized defects of the vasculature, and usually affect a limited number of vessels in a restricted area of the body. They are subdivided into vascular malformations and vascular tumours. Most are sporadic, but Mendelian inheritance is observed in some families. By genetic analysis, several causative genes have been identified during the last 10 years. This has shed light into the pathophysiological pathways involved. Interestingly, in most cases, the primary defect seems to affect the characteristics of endothelial cells. Only mutations in the glomulin gene, responsible for hereditary glomuvenous malformations, are thought to directly affect vascular smooth-muscle cells.
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Affiliation(s)
- P Brouillard
- Laboratory of Human Molecular Genetics, Christian de Duve Institute of Cellular Pathology and Université Catholique de Louvain, Brussels, Belgium.
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D'Acri AM, Ramos-e-Silva M, Basílio-de-Oliveira C, Cerqueira A, Monteiro D, Pretti G, Longo C, Monteiro E. Multiple glomus tumors: recognition and diagnosis. Skinmed 2002; 1:94-8. [PMID: 14673334 DOI: 10.1111/j.1540-9740.2002.01628.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
BACKGROUND Glomus tumor is a benign neoplasm of uncommon occurrence in daily practice, more frequently observed as a single painful lesion, at the distal phalanges of the fingers. Multiple presentation is very rare, with fewer than 200 reports, usually presenting as small angiomatous lesions with discrete pain. OBJECTIVES The study's objective was to analyze the epidemiologic, clinical, therapeutic, and histopathologic aspects in a series of six cases of multiple glomus tumors. RESULTS All patients were men, between 12-45 years of age. The tumor was congenital or appeared between 3-25 years of age. The clinical picture oscillated between three to 10 lesions, as macules, nodules, or tumors, with colors varying from bluish, brown-bluish, violet, to normochromic. The lesions were detected in the trunk and one or more members, not affecting the head, hands, and feet. Pain was discrete or absent. Incisional biopsy for histopathologic evaluation with the hematoxylin-eosin staining confirmed the diagnosis of glomus tumor in all cases. It showed the characteristic glomus cells and vascular spaces. The complete excision of the tumorous plaque was performed in one patient and a complex corrective procedure is still to be performed for one aberrant tumor in another case. The other patients received advice about their disease and were asked to periodically return. CONCLUSION Because this is a very uncommon illness, the present series allowed the demonstration of the wide variety of epidemiologic and clinical aspects described in the literature, with the presentation of elements that may improve its recognition and diagnosis.
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Affiliation(s)
- Antonio Macedo D'Acri
- The Universidade Federal do Rio de Janeiro (UFRJ), Praça Saens Pena 45/1101, 20520-090 Rio de Janeiro, Brazil.
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Mayr-Kanhäuser S, Behmel A, Aberer W. Multiple glomus tumors of the skin with male-to-male transmission over four generations. J Invest Dermatol 2001; 116:475-6. [PMID: 11231328 DOI: 10.1046/j.1523-1747.2001.12794.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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11
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Petropoulos AE, Luetje CM, Camarata PJ, Whittaker CK, Lee G, Baysal BE. Genetic analysis in the diagnosis of familial paragangliomas. Laryngoscope 2000; 110:1225-9. [PMID: 10892701 DOI: 10.1097/00005537-200007000-00030] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES In the management of two related patients with multicentric glomus jugulare tumors, given the incidence of 1:30,000 with approximately 20% familial cases, our objective was to review the genetic characteristics and inheritance patterns of these tumors and to determine what molecular genetic screening possibilities exist for the phenotypically normal family members. In addition, our aim was to review the incidence of various multicentric paraganglioma (PGL) tumor location combinations. METHODS Molecular genetic linkage analysis testing was performed on the 2 patients and 14 other unaffected family members. We report the results of this screening and review the literature on the incidence and genetics of paragangliomas. RESULTS The inheritance pattern in the literature demonstrates autosomal dominant transmission with maternal imprinting (inactivation). The proclivity for multicentric origin increases to 26% in familial cases, as reflected in our patients. In addition to the two patients, four unaffected family members demonstrated the presence of the disease haplotype at chromosome band 11q23, which indicates a very high likelihood of developing a paraganglioma, given the highly penetrant nature of the disease. CONCLUSIONS It is clear that the familial PGL gene locus is situated at chromosome 11q23. The gene itself and its exact degree of penetrance, however, still await identification. Since early detection of paragangliomas reduces the incidence of morbidity and mortality, genotypic analysis as a screening tool in families of affected patients should play a front-line diagnostic role, leading to more timely and cost-effective patient management.
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Affiliation(s)
- A E Petropoulos
- Otologic Center and Midwest Ear Institute, Kansas City, Missouri 64111, USA
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Blume-Peytavi U, Adler YD, Geilen CC, Ahmad W, Christiano A, Goerdt S, Orfanos CE. Multiple familial cutaneous glomangioma: A pedigree of 4 generations and critical analysis of histologic and genetic differences of glomus tumors. J Am Acad Dermatol 2000. [DOI: 10.1067/mjd.2000.103810] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Abstract
We describe a 54-year-old patient with an unusual localization of localized multiple glomus tumors. She had several nodules on the left mandibular area, lower lip, and anterior part of the buccal mucosa. A biopsy taken from the left mandibular area showed cystically dilated vessels lined by endothelial cells and a few outer layers of glomus cells in the dermis to subcutis. Localized multiple glomus tumors are rare, and both their facial and oral mucocal localization are extremely rare.
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Affiliation(s)
- H J Yu
- Department of Dermatology, Hanyang University Kuri Hospital, Korea
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Looi KP, Teh M, Pho RW. An unusual case of multiple recurrence of a glomangioma. JOURNAL OF HAND SURGERY (EDINBURGH, SCOTLAND) 1999; 24:387-9. [PMID: 10433466 DOI: 10.1054/jhsb.1998.0013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Glomus tumour is a benign lesion arising from the glomus apparatus of the skin and subcutaneous tissue. Glomangioma is the angiomatous variant, which is uncommon. We report a very rare presentation of a glomangioma with multiple recurrences. We advocate preoperative angiography to delineate the extent of the lesion to facilitate complete excision.
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Affiliation(s)
- K P Looi
- Department of Hand and Reconstructive Microsurgery, National University Hospital, National University of Singapore
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Abstract
Glomus tumors can be classified into solitary and multiple glomus tumors. Congenital multiple glomus tumors are extremely rare, and only 12 cases have been reported in the world literature. We describe the first case with giant congenital multiple patch-like glomus tumors that show partial atrophy.
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Affiliation(s)
- T Y Yoon
- Department of Dermatology, College of Medicine, Chungbuk National University, Cheongju, Korea
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Graadt Van Roggen JF, Joekes EC, Welvaart K, Van Krieken JH. Unusual presentation of multiple subcutaneous glomus tumours of the lower limb with extensive glomus cell hyperplasia. Histopathology 1999; 34:474-5. [PMID: 10231426 DOI: 10.1046/j.1365-2559.1999.0676c.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Iqbal A, Cormack GC, Scerri G. Hereditary multiple glomangiomas. BRITISH JOURNAL OF PLASTIC SURGERY 1998; 51:32-7. [PMID: 9577316 DOI: 10.1054/bjps.1997.0116] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Hereditary multiple glomangiomas are an interesting rare problem which can either present as multiple painful cutaneous lesions or, rarely, a cosmetic challenge due to site, size or number of lesions. It may also pose a diagnostic dilemma, which can only be settled by biopsy. Malignant change in glomangioma is extremely rare and only a few cases are well documented in literature. A case report of this condition, along with extensive review of the literature, is presented. The prognosis of various forms of glomangiomas and efficacy of diagnostic and therapeutic tools is discussed.
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Affiliation(s)
- A Iqbal
- Department of Plastic Surgery, Derriford Hospital Plymouth, UK
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BHUSHAN M, KUMAR S, GRIFFITHS C. Multiple glomus tumours, Coats' disease and basic fibroblast growth factor. Br J Dermatol 1997. [DOI: 10.1111/j.1365-2133.1997.tb03758.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Brathwaite CD, Poppiti RJ. Malignant glomus tumor. A case report of widespread metastases in a patient with multiple glomus body hamartomas. Am J Surg Pathol 1996; 20:233-8. [PMID: 8554113 DOI: 10.1097/00000478-199602000-00012] [Citation(s) in RCA: 75] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Glomus tumors are characteristically benign solitary tumors. A few cases of malignant glomus tumors have been reported; however, they are usually only locally invasive, and metastases are exceedingly rare. We report a case of widespread metastases of a malignant glomus tumor involving the skin, lungs, jejunum, liver, spleen, and lymph nodes in a 63-year-old man with end-stage chronic renal failure. At autopsy, multiple glomus body hamartomas were also noted throughout the dermis proximal to the skin tumors. Histologically, the tumor was composed of monotonous round cells in solid sheets and investing numerous capillary-sized vessels. Approximately four to six mitoses were present per high-power field. The tumor cells were strongly immunoreactive for actin and vimentin, and ultrastructurally there were whorls of microfilaments with focal condensations. This case is exceptional because of its aggressive course.
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Affiliation(s)
- C D Brathwaite
- Arkadi Rywlin Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center of Greater Miami, FL, USA
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