INTRAOSSEOUS SPINAL GLOMUS TUMORS

Rare presentation of a primary intraosseous glomus tumor in the humerus of a teenager

A glomus tumor is a benign mesenchymal tumor comprised of cells that resemble the perivascular modified smooth muscle cells of the glomus body. Glomus tumors typically appear in the superficial lesions of the soft tissue in the extremities, such as the subungual region. However, their occurrence in the bone is rare, with only about 30 cases reported to date. Half of these cases involved the distal phalanges of the fingers or toes, with only three reported cases involving the long bones. Here, we present the first case, a primary glomus tumor in the humerus of a 14-year-old female. An osteolytic and cystic lesion was detected after a pathological fracture occurred during exercise. Despite the tumor's large size, no pathological findings indicated malignancy. The fracture healed through conservative treatment, while the tumor was effectively managed with curettage. Appropriate medical care can be provided to patients by focusing on pathological findings.

[Posterior mediastinal glomangiomatosis: Exceptional location of a rare tumour]

INTRODUCTION

Glomangiomatosis is a benign tumour proliferation which develops from the glomus cells in the wall of a vessel, and which contains abnormal venous capillaries. Its usual location is dermal at the extremities, mediastinal presentation is exceptional.

OBSERVATION

A 63-year-old patient, followed for scoliosis, was admitted for a spontaneous haemothorax. The CT scan found hypervascularized left paravertebral masses. Thoracoscopy with biopsy provided the diagnosis of a glomus tumour. Given that its diffuse nature makes surgical excision difficult and the risk of intraoperative bleeding very high, treatment with interleukin alpha 2 was proposed to the patient. After a 3-year course, we did not observe any evolutionary change in the lesions.

CONCLUSION

Glomangiomatosis is an insidiously evolving vascular tumour which must be considered in the presence of vascular lesions. The reference treatment is surgical excision when possible. On the other hand, hasty surgery in diffuse forms remains dangerous given the haemorrhagic nature of this tumour.

Minimally invasive resection of a glomus tumor of the thoracic spine: a case report and literature review

Objective

Spinal involvement of glomus tumors is extremely rare. We herein present a case of a spinal glomus tumor and reviewed the literature to identify the most effective surgical treatment of spinal glomus tumors.

Methods

A 48-year-old man presented with a huge paravertebral space-occupying lesion. In this report, we present the diagnostic process and surgical procedure in this case and review the literature of glomus tumors with spine involvement.

Results

We suspected a primary diagnosis of neurilemmoma based on the imaging results; however, the postoperative pathologic examination confirmed a glomus tumor. Considering the size of the tumor and involvement of surrounding areas, we performed complete tumor resection and unilateral fusion with pedicle screws at the T2 to T4 level. This unilateral approach with fixation was less invasive than the standard open posterior approaches that are used when one side of the spinal canal is intact without bony destruction.

Conclusions

Surgical resection is a suitable treatment for most symptomatic glomus tumors. For most glomus tumors with spine involvement, total tumor resection with suitable internal fixation and fusion is recommended.

Unusual imaging presentation of spinal glomus tumor: case report

A glomangioma, also known as a glomus tumor, is a benign lesion and had rare occurrence of spine region. In this study, we presented a spinal glomus tumor with an unusual radiological presentation, which is different from osteolytic intraosseous patterns illustrated before. A 26-year-old male with compressive myelopathy caused by epidural intraspinal lesion over T11 level. Radiological presentation revealed reactive sclerotic change over the body and lamina was found on the same level in computed tomography (CT) examination. Surgical resection was applied for en bloc tumor resection. The patient had well recovery after surgery. The pathology revealed cavernous haemangioma-like vascular structures, compatible with glomus tumor. Radiological diagnosis of spinal glomus tumor has limitation and difficulty preoperatively. Surgical intervention was suggested for patient with clinical neurological deficit and pathological approval.

Paravertebral glomangioma mimicking a schwannoma

Glomus tumors are rare benign neoplasms usually arising from soft tissues. Surgical removal seems to be the best treatment. Here, we report the case of a 52-year-old female patient referred for chronicback pain, revealing a thoracic paravertebral tumor with no osseous extension. After surgical removal,this tumor turned out to be a glomangioma. Differential diagnosis with other more frequent tumors,such as schwannoma, is particularly difficult. A review of the relevant literature will be presented. A better knowledge of the natural history of those tumors, as well as the therapeutic options available, are necessary for spinal surgeons who may encounter such presentations.

Percutaneous radiofrequency ablation of primary intraosseous spinal glomus tumor

The glomus tumor is a rare, benign, but painful vascular neoplasm arising from the neuromyoarterial glomus. Primary intraosseous glomus tumor is even rarer, with only about 20 cases reported in the literature so far, 5 of which involved the spine. Surgical resection is currently considered the treatment of choice. We herewith present an uncommon case of primary intraosseous spinal glomus tumor involving the right pedicle of the eleventh thoracic vertebra (T11). To our knowledge, this is the first case of primary intraosseous spinal glomus tumor successfully treated by percutaneous CT-guided radiofrequency ablation (RFA).