Glomus tumor as a cause of oncogenic osteomalacia

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.

Glomus tumors around or in the knee: a case report and literature review

BACKGROUND

Glomus tumors commonly affect the extremities, especially subungual. And glomus tumors rarely occur around knee, which are often misdiagnosed. A lack of experience with glomus tumors is likely the cause.

CASE PRESENTATION

A 42-year-old female presented with continuous dull pain of right knee for the past 7 years. Severe pain was experienced after walking a few hundred meters or climbing up or down stairs. The patient had a slight limp, and the lateral superior aspect of her right knee was tender to palpation. The range of motion and skin around her right knee were normal. Magnetic resonance imaging revealed a well-defined abnormal lesion confluent with the periosteum on the femoral lateral supracondylar. She was finally diagnosed with glomus tumor according to pathological results. After surgery, the pain disappeared, and the patient was discharged three days postoperatively. At the 18-month follow-up visit, the patient reported sustained pain relief, and regular follow-ups were continued. Additionally, 30 published reports documenting 36 cases of glomus tumors around the knee were reviewed, which showed that 20% of all reported cases of glomus tumor around the knee had a history of trauma. The median age for male with glomus tumor was greater than that of female; however, the median duration of illness between the two groups was equivalent. The mean diameters of glomus tumors ranged from 4 to 65 mm, and locations around the knee included the knee joint cavity, soft tissue (e.g. popliteal fossa, patellar tendon, iliotibial band, and Hoffa's fat pad), distal femur, and proximal tibia.

CONCLUSION

Literature review demonstrated that no significant differences were found between male and female with glomus tumor in regard to location (left or right side) and illness duration. It was noting that a history of trauma may be a cause of glomus tumor and approximate 94.4% of glomus tumors was benign. The most effective therapy accepted for glomus tumors is complete surgical excision, and recurrence was rare after complete surgical excision.

Glomus tumors associated with the bone and joints: a review of 91 cases

Background

Glomus tumors (GTs) commonly affect the subungual soft tissue but rarely affect the bone and joints. Meanwhile, GTs associated with the bone and joints have been misdiagnosed for decades.

Methods

The PubMed, Embase, and Web of Science databases were searched, and primary data extracted from selected articles were quantitively analyzed.

Results

The number of male and female patients was 52 and 39, respectively, and the right side was more commonly affected than the left. The median age at onset of male and female patients was 43.61±19.20 and 33.16±14.87 years, respectively, and the median illness duration was 3.00 (1.00, 10.00) and 3.00 (0.50, 7.50) years, respectively. The median follow-up time was 12 months, and the median time to recurrence or metastasis was also 12 months. Of the 91 total cases, 3 had a malignant pathological type and 4 had an uncertain malignant potential. Moreover, five cases recurred postoperatively, including two malignant cases, two benign GTs, and one case of glomangiomatosis. Of the 54 patients with recorded data on trauma, 12 reported a definite history of trauma.

Conclusions

Interestingly, the history of trauma is an important cause of GTs. The most common site of extra-subungual tissue is the knee, especially in young adults. Surgical removal was the most commonly used treatment method, and radiotherapy and chemotherapy can be combined if necessary. Furthermore, patients should be followed up for at least 2 years postoperatively to monitor for possible recurrence. Fortunately, most patients with GTs have a good prognosis.

Left maxillary sinus tumour-induced hypophosphataemic osteomalacia and combined with thyroid papillary carcinoma: a case report and literature review

Tumour-induced osteomalacia (TIO) is a rare disease characterised by hypophosphataemia and clinical symptoms of osteomalacia. Herein we report the case of a 29-year-old man who was admitted to hospital with progressive bone pain and was diagnosed with TIO caused by maxillary sinus tumours. In the preoperative evaluation, it was found that the patient had thyroid malignant tumours at the same time. Two operations were performed separately on the left maxillary sinus tumour and thyroid tumour after complete examination. After tumour resections, the symptoms of bone pain were relieved and the level of blood phosphorus was restored, long-term replacement therapy was needed for thyroid. When a patient is diagnosed with TIO, it is necessary to screen for the presence of other malignant tumours and explore the treatment options in order to benefit patients preferably.