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Summary Glomus tumours are distinctive neoplasms arising in the cells of the glomus body. Histologically they resemble modified smooth muscle cells. It usually occurs over the limbs. However, several unusual sites of occurrence have been described. These include the patella, chest wall, bone, heart, stomach, eyelid, lung, rectum, etc. Tracheal tumours have been described. We discuss a case of glomus tumour arising from the proximal trachea in a 43-year old male with complaints of intermittent hemoptysis and chest pain, and describe resection of this tumour using a rigid bronchoscopic technique. An overview of tracheal glomus tumours is presented.

The skin of macroscopically distinct regions (hairy skin, vibrissal fields, buccal ridge, and rhinarium) of the head of the blind mole-rat, Spalax ehrenbergi, was studied by routine histological methods. Few guard and several soft vellus hairs are organized into tufts that grow from a group of hair follicles localized in an invaginated compound cavity. We suggest that this hair arrangement may be a burrowing adaptation to match frictional resistance. The follicles and the compound cavity possess either well developed complex striated musculature or errector pili muscles. There are no structural specializations (sweat glands, glomus bodies) to enhance thermoregulatory (heat dissipative) capacities in the hairy skin of the head. Vibrissae penetrate the epidermal surface as single hairs. They are microscopically normally developed and arranged in vibrissal fields according to a basal mammalian pattern. Most of them are, however, relatively short and inconspicuous. The mystacial vibrissal field is horizontally divided by a prominent buccal ridge which is probably involved in bulldozing. The hairs in the ridge leave the compound cavity singularly. The follicles of guard hairs and bristles are equipped with well developed pilo-Ruffini complexes indicating that the buccal ridge may serve also as a tactile organ. The glabrous skin of the rhinarium has a highly interdigitated dermal-epidermal interface. The dermal papillae possess simple lamellated and/or simple Meissner's corpuscles and few Merkel cell-axon-complexes indicating that the skin of the rhinarium may be particularly sensitive to perception of vibrations.

A glomangioma is a rare benign tumor of a glomus body. We report the case of a large (6 cm × 4 cm × 4 cm) painless glomangioma on the dorsum of a 52-year-old male's left foot. We believe this to be one of the largest reported.

Background Glomus tumours are neoplasms arising from cells of the neuromyoarterial glomus bodies, which almost always occur in a subungual location. A lung location is extremely rare, with few cases reported in the literature. Clinical case The case is presented of a 33 year-old male, with non-productive cough, dyspnoea at rest, intermittent fever, and mild pain in rib cage. A chest radiograph showed a consolidation in the left lung, and computed tomography revealed a lesion in the hilum that extended to the bronchus of the lingula obstructing, and causing post-obstructive pneumonia. A biopsy was obtained by rigid bronchoscopy biopsy, which showed a well circumscribed tumour constituted by intermediate-sized cells, and abundant cytoplasm that are arranged in a pattern surrounding numerous thin-walled blood vessels, with no pleomorphism, significant mitotic activity or necrosis. Immunohistochemistry revealed diffuse positivity with smooth muscle actin, vimentin, caldesmon; focal reactivity with desmin and CD117, CD34 highlights the vascular pattern. Ki67 proliferation rate was 1%. Synaptophysin, EMA and cytokeratin cocktail were negative, making the diagnosis of glomus tumour. Conclusions Glomus tumours are rare neoplasms that usually appear in the dermis and subcutaneous tissue, where it is common to find glomus bodies. Occasionally glomus tumours can occur in extra-cutaneous sites such as the gastrointestinal tract, bone and respiratory system, with this case being a new case of rare lung location.

A glomus tumor is a benign vascular tumor derived from the modified smooth muscle cells of the glomus body. The lesions develop as small blue-red nodules that are usually located in the deep dermis or subcutis of the upper or lower extremity. The single most common site is the subungual region of the finger, but other common sites include the palm, wrist, forearm and foot. In the present study, we report the case of a 45-year-old patient diagnosed with extradigital glomus tumor of subcutaneous tissue of elbow. Histopathological examination revealed that the tumor was a well-circumscribed nodule with focal invagination of tumor cells into the adjacent upper dermis. The tumor was composed of solid sheets of cells interrupted by vessels of varying size. Immunohistochemically, the tumor cells were reactive for smooth muscle actin (SMA) and vimentin (VMT). The majority of glomus tumors may be treated adequately by the correct diagnosis and simple excision. However, extradigital glomus tumors are occasionally difficult to diagnose owing to their non-specific clinical characteristics, including unusual sites and symptoms which vary compared with those of classical glomus tumors. Therefore, it is crucial to include glomus tumors in a differential diagnosis of patients with extradigital lesions.

Glomus tumor is a benign, subcutaneous neoplasm which usually arises in areas that are rich in glomus bodies, most commonly the digital area, and usually appears as a painful nodule. Glomus tumor of the breast is extremely rare, and there has been only limited information reported in the literature to date. We herein present a case of a glomus tumor arising from the breast, showing a well-circumscribed, hypervascular, solid and hypoechoic tumor within the retromammary fat. The tumor was resected and the patient's pain was relieved immediately after the surgery. She remains well without any symptoms after a year. This report describes a unique case of this type of tumor.

Glomus tumor is a rare mesenchymal neoplasm composed of cells that resemble the modified perivascular smooth muscle cells (glomus cells) of the normal glomus body. A glomus tumor can appear in any part of the body, although it mostly appears in the extremities, especially in the subungual area of the hand. It has been less commonly reported in the foot. A case of glomus tumor of the pulp of the hallux is described in the present report.

Glomus tumors are rare mesenchymal neoplastic lesions arising from glomus bodies that are involved in skin thermoregulation. They are mostly benign tumors, and malignant variants have been rarely reported. The subungual zones of fingers and toes are the most frequent sites of observation. Glomus tumors arising in visceral organs of the gastrointestinal tract are exceedingly rare. Stomach antrum and intestinal duodenum are the most frequent organs involved. No single case of glomus tumor involving intestinal ileum has been previously reported in the English medical literature. To the best of our knowledge, we report the first case of malignant glomus tumor (glomangiosarcoma) of intestinal ileum in a 29-year-old female patient who presented with a 1-month history of a tender pelvi-abdominal mass, constipation, vomiting, and melena. The intestinal ileum glomus tumor was resected, and histopathological diagnosis was consistent with glomangiosarcoma. A postoperative 6-month followup failed to show any evidence of tumor recurrence.

Glomus tumours (GTs) resemble the normal glomus body and have a predilection for skin and subcutaneous tissue. Although the majority of glomus tumours are small, benign neoplasms that occur in the dermis or subcutis of the extremities and cases of atypical or malignant variants have been reported. We report a case of a man who presented with a 1-year history of subcutaneous nodule in the right scapular area which was mildly tender. The nodule measured 2 cm. Microscopic examination showed features of glomus tumour with increased mitotic activity. These features, by current definition, would suggest glomus tumour of uncertain malignant potential. Three months later, he presented with recurrence. During his metastasis work-up, we noticed bilateral pulmonary metastasis. Metastasising GTs are rare. The patient underwent wide local excision and received chemotherapy.

The unusual occurrence of a glomus tumor within a small, deep dermal nerve is reported. This phenomenon has been described previously only once in the literature. The lesion appeared as a painful cutaneous nodule in the shoulder of a 67-year-old woman. Microscopically, a typical solid, smooth muscle actin-positive glomus tumor was seen, encircled completely by neural tissue in the deep dermis. There was no extension of the tumor beyond the nerve. Immunohistochemically, the nerve fibers surrounding and within the tumor were positive for S-100 protein and neurofilament. The presence of perineurium surrounding the glomus tumor was confirmed by a layer of epithelial membrane antigen-positive cells. In view of the absence of normal glomus bodies in the nerves, an origin from a less specialized perivascular cell is proposed.

Glomus tumours are benign tumours typically arising from the glomus bodies and primarily found under the fingernails or toenails. These rare neoplasms account for

Glomus tumors are uncommon, benign, small neurovascular neoplasms derived from glomus bodies in the reticular dermis. Glomus bodies are found throughout the body to regulate body temperature and skin circulation; however, they are concentrated in the fingers and the sole of the foot. The typical presentation is a solitary nodule in the subungual or periungual area of the distal phalanx. The primary treatment of choice is surgical removal. We investigated expression of vascular endothelial growth factor (VEGF) using immunohistochemistry in glomus tumors of the fingers. All five glomus tumor samples were positive for VEGF expression. VEGF immunoreactivity was largely localized to the cytoplasm of tumor cells, suggesting a contribution of VEGF to the vascularization of glomus tumors.

Pulmonary glomus tumors are extremely rare, with only 19 cases having been reported worldwide. The glomus body is considered to be related to the regulation of body temperature, but the reported cases were not associated with hyperpyrexia. Here, we describe a 28-year-old man with hyperpyrexia and anemia complicated with a coin lesion of the right lung. After resection of the upper lobe of the right lung by video-assisted thoracoscopic surgery, all of the patient's symptoms disappeared. The pathologic analysis reported a rare pulmonary glomus tumor. The disease had not recurred by 1 year after operation.

Glomus tumours are rare, benign tumours of the glomus body, most frequently located in the subungual region of digits, palms and soles, but they have been reported throughout the body. Our patient is a 65-year-old man who presented with a 3-year history of a very painful area on his left upper arm. The overlying skin was normal and there was no lesion to palpate, but the symptoms were very striking, warranting further investigation. An exploratory operation identified a prominent vein with a noticeable bulge in the vessel wall. The vein was ligated and excised. On dissection of the vein, a tumour was present within its lumen. Histological examination and immune profile of the tumour confirmed an intravascular glomus tumour. Following surgical excision, symptoms resolved.

Glomus tumor is an uncommon benign tumor rising from the glomus bodies. It is most often found on limbs and rarely involve the head and neck. In this report, we present the 31st documented case of a intranasal glomus (nasal vestibular) tumor, an extremely rare localization.

Glomus tumors are rare benign neoplasms. They typically present with a triad of severe pain, point tenderness, and cold sensitivity. Most glomus tumors will form well-circumscribed nodules, and excisional biopsy of masses detected by ultrasonography or magnetic resonance imaging of the lesion can relieve the symptoms. We describe a 30-year-old female patient with nontumorous glomus cell proliferation with clinical symptoms similar to those of glomus tumors. The lesion was treated by exploration and excision, with a satisfactory clinical outcome.

Glomus tumors are rare soft tissue neoplasms resembling the normal glomus body, which is a specialized form of arteriovenous anastomosis that regulates heat. The molecular genetics of sporadic glomus tumors has not been studied. We genotyped tumors from 28 patients (16 female patients and 12 male patients) ranging from 13 to 77 years and correlated the results with the tumor site (15 finger/1 hand/4 arm/7 leg/1 eyelid), Ki-67 index, and clinical follow-up. Tumor DNA from paraffin-embedded tissue was screened by multiplex polymerase chain reaction and mass spectroscopy, using a panel covering 370 mutations across 30 genes, including AKT1, BRAF, CTNNB1, EGFR, ERBB2, FGFR1/2/3, HRAS, KIT, KRAS, MEK1/2, NRAS, PDGFRA, and PIK3CA. A BRAF V600E mutation was identified in 3 cases, all of which occurred in proximal locations (upper shin, thigh, and upper arm). Two of the patients with BRAF-mutated tumors were quite young (21 and 13 years) and one of the BRAF-mutated tumors recurred in 3 years. A KRAS G12A mutation was found in tumor removed from the finger. Ki-67 index did not correlate with genotype. To our knowledge, this is the first report of oncogenic mutations in sporadic glomus tumors.

Glomus tumours of the fingers and toes develop secondarily to the biallelic inactivation of the NF1 gene and are part of the NF1 tumour spectrum. Glomus tumours are small, benign neoplasms that arise from the glomus body, a thermoregulatory shunt commonly found in the fingers and toes. Glomus tumours typically present with at least two of the features of the classic triad of symptoms: severe paroxysmal pain, point tenderness and cold hypersensitivity. Sporadic glomus tumours of fingers and toes are solitary and affect women of middle age. NF1-associated glomus tumours can be multifocal and also demonstrate a female predominance. Treatment is surgical, although tumour or pain recurrence is not uncommon. Pathogenic germline and somatic mutations (or loss of heterozygosity) of NF1 have been reported in nine NF1-associated glomus tumours, including two (22 %) that underwent mitotic recombination of chromosome arm 17q. Consistent with NF1 biallelic inactivation, monoclonal expansion has been documented in glomus tumours. Loss of neurofibromin function in NF1 −/− glomus cells resulted in RAS-MAPK hyperactivation. There is no evidence for NF1 inactivation or overactivation of the RAS-MAPK pathway in glomus cells from sporadic glomus tumours. A variety of copy-number changes, as determined by SNP arrays, have been reported in NF1-associated glomus tumours.

Glomus tumors arise from the subcutaneous glomus body, which is an arteriovenous anastomosis involved in the regulation of cutaneous blood circulation. Complete removal of the tumor is required for treatment. However, some reports mention recurrence of the tumor, and postoperative nail deformity in subungual cases has also been reported. Cases of histologically diagnosed glomus tumors are reviewed, and a technique to prevent postoperative nail deformity is introduced.

Glomus tumors are benign lesions composed of vessels and glomocytes in varying proportions. The histological appearance of the tumors depend upon the ratio of the vascular to the glomus cells and their differentiation as well as upon the amount and composition of the stroma. The aim of the present study was the establishment of criteria for the distinction of glomus tumor-like malformations from neoplasms with glomus cell differentiation. Using a panel of monoclonal and polyclonal antibodies (vimentin, a-smooth muscle actin, desmin, pan-keratin, low molecular weight cytokeratin, EMA, NSE, S-100 protein, Factor VIII, a1-ACT) glomus tumors could be separated into three types: vascular, cellular with myxoid stroma and cellular, solid type. In the first two types the tumor growth is composed of all three components found in normal glomus body, but in a haphazard fashion and thus might be considered as tumor-like malformations. The third type is composed of perivascular arranged cells most of which acquire the phenotypical characteristics of glomocytes. This last tumor probably represent the neoplastic variant of the group of lesions designated by the term glomus tumor. Pathol Res Pract

A glomus tumour is a benign swelling arising from the neuromyoarterial canal system (Sucquet–Hoyer canals of the skin glomus body) w1x. It typically causes exquisite pain following mechanical and thermal stimulation w2x. Most glomus tumours occur in the subungal region w3–5x. However, they have also been described in the digital nerves w6x, radial nerve w7x, respiratory system w8–11x, gastrointestinal tract w12–14x, intraosseous w15–17x thoracic spine w15x, coccyx w16x, sacrum w17x, fallopian tubes w18x, head and neck region w19–21x and the rotator cuff w22x. We describe the second case reported in the literature of an extradigital glomus tumour causing knee pain. The diagnosis was delayed, but the pain disappeared after complete excision and the glomus tumour was confirmed by histology.

Glomus tumors are benign neoplasms that develop from normal glomus bodies. These tumors are most commonly found in the nail bed of the hands and are characterized by point tenderness, and temperature sensitivity. Histologically, they are classified into three groups, the least common is glomangiomyoma, which is a variant distinguished by its predominant smooth muscle cellular content. This report describes a patient with a subungual glomangiomyoma that was surgically excised with a favorable outcome. The tumor is unusual for this location; a location common for typical glomus tumors. It presented without the typical associated symptoms of point and temperature sensitivity. This may suggest that the histological type may be more important in predicting the clinical presentation than the anatomical location of the glomus tumor.

Introduction. Glomus tumors (GTs) are benign neoplasm originating from the glomus body, commonly described in subungual region. The involvement abdominal is rare. Our aim is to describe a case of glomus tumor of the stomach that presented upper gastrointestinal bleeding. A 34-year-old woman was admitted with upper gastrointestinal bleeding and underwent an upper endoscopy that showed bleeding arising from an ulcerated lesion, treated by sclerosis therapy. A new endoscopy confirmed a submucosal lesion in upper portion of the stomach. During the laparotomy, a tumor at the upper anterior wall of gastric body was found and resected by a vertical gastrectomy. The pathological exam revealed hyperplastic smooth muscle fibers of the muscularis propria of the stomach wall, surrounded by hyaline stroma. The immunohistochemistry panel was positive for smooth muscle actin and type IV collagen, with low rate of mitosis studied by Ki-67 which allowed the final diagnosis of a gastric glomus tumor.Discussion. The majority of intraperitoneal glomus tumors occur in the stomach, and it is phenotypically similar to those localized in peripheral sites. Gastric GT generally is a benign tumor although it can be malignant and have the potential to metastasize.Conclusion. Even though gastric glomus tumor is rarely described, it should be considered as a possible cause of a major upper gastrointestinal bleeding.

Glomus tumors are benign neoplasms originating from the glomus body. They are most frequently found in the nail bed of the hands, and their occurrence in other parts of the body is rare. A 75-year-old man presented with left anterior knee pain of 30-year history, that became more intense with light touch or clothing and increased in severity despite medical treatment. Physical examination showed a painful, soft, mobile, red-purple colored mass, 2 x 2 cm in size, at the inferior border of the patella. Plain radiographs showed no pathology other than mild degenerative changes. Magnetic resonance imaging revealed a mass lesion, 1.5 x 1.1 x 2 cm in size, located at the anterior border of the patellar tendon, which showed hypointensity on T1A-weighted sequences and hyperintensity on T2-weighted sequences and T2-weighted sequences with fat saturation. The mass was excised and the histopathological diagnosis was reported as glomangioma. Postoperatively, the patient had no complaint of pain and no recurrence was observed during a two-year follow-up.

Background Glomus tumor is an uncommon neoplasm derived from cells of the neuromyoarterial glomus or glomus body. Most glomus tumours occur in the dermis and subcutaneous tissues. A case of a primary pulmonary glomus tumour originating in the right upper lobe is presented. Case presentation A 74-yr-old male was admitted with siccus cough, dyspnea and right-sided chest pain. Computed tomography of the thorax revealed a 4 cm growth of the right upper lobe. Fiberoptic bronchoscopy demonstrated an endobronchial hypervascular mass causing obstruction of the apical segmental bronchus. Pathology report was consistent with pulmonary glomus tumor. The patient underwent a typical right upper lobectomy with mediastinal lymph node dissection. Twelve months later he is free of disease. Conclusion Occasionally glomus tumors can occur in extracutaneous sites such as the gastrointestinal tract, bone, genitourinary system and respiratory tract. Primary pulmonary glomus tumors are very rare (our case is the 19th one presented in the international literature) and are often confused with other solid neoplasms such as carcinoids, hemangiopericytomas and tumors belonging to the family of Ewing's sarcoma/primitive neuroectodermal tumours.

Glomus tumors, as a type of quite rare neoplasms, originate from modified smooth muscle cells of the glomus body whose function is to regulate blood flow within arteries according to the body temperature. Although these tumors most commonly occur in the peripheral soft tissues, especially in the distal parts of extremities, there have been rare reports of visceral involvement (Lorber et al., 2005) [1]. We report a case of gastric glomus tumor, which was preoperatively diagnosed by ultrasonic endoscopy as a gastric stromal tumor and treated by endoscopic submucosal dissection (ESD).

A 52-year-old female patient presented with an 8-year history of progressively intense pain, cold sensitivity, and severe tenderness to palpation of the ulnar side of the tip of her right little finger. Subsequent diagnostic evaluation with ultrasonographic imaging revealed the presence of a glomus tumor in the tender area. Glomus tumors are benign, occurring in the vascular hamartomatous tubercles of the glomus body, which is a myoarterial apparatus typically found in the reticular dermis of the skin. Distal glomus tumors are relatively uncommon, and account for approximately 1% of all hand tumors. Most of them are located in the subungual area because of its high concentration of glomus bodies. We report a case of a glomus tumor with a typical triad of symptoms, yet with a rare location : on the pulp of the ulnar aspect of the distal phalanx of the right little finger.

Glomangiomas of the skin, currently named glomuvenous malformations (GVMs), are benign vascular lesions composed of thin-walled distorted blood vessels, surrounded by variable rows of glomus cells. These cells resemble the modified smooth muscle cells of the normal glomus body. Glomuvenous malformations occur after both alleles of the gene encoding for glomulin, a molecule involved in smooth muscle cell differentiation, are hit by a loss-of-function mutation. Multiple GVMs are rare and often congenital, but they may also appear later in life. In this report we describe a 39-year-old man who developed unilateral segmental GVMs on his trunk in early childhood, with the histological features of glomangiomas. As several satellite lesions emerged at distant skin sites later in life, our case probably represents type 2 segmental GVMs, caused by localized loss of heterozygosity in an individual carrying a heterozygous germline mutation in the glomulin gene.

A 44-year-old man presented with a 5-year history of localized pain on his back, and a 1.5-cm round, touch-induced painful mass was palpated. A subsequent diagnostic evaluation revealed the presence of a glomus tumor. Glomus tumors are rare, benign, small vascular tumors, which originate from glomus bodies present in the reticular dermis. Glomus tumors constitute less than 2.0% of all primary soft tissue tumors, approximately 80% of the lesions are located in the upper extremity, and more than 75% are subungually located. However, many locations have been reported in the literature. Nevertheless, to the best of our knowledge, this glomus tumor that occurred on the back is very rare.

Glomus tumors are usually thought of as benign tumors although some malignant cases have been reported. These tumors arise from the glomus body and are commonly observed in the dermis or subcutis, but rarely in visceral organs. Here, we report a 37-year-old female who initially presented with epigastric discomfort. The preoperative diagnosis was a gastrointestinal stromal tumor. A minilaparotomy was done with an incision length of 4 cm followed by wedge resection. The final pathologic diagnosis was a gastric glomus tumor. We have reviewed the only five cases of gastric glomus tumors that have been reported to date in Taiwan, including the present case, and compare these cases with those reported in other countries. The age of onset ranged from 35 to 69 years (median, 41 years) with female dominance (4 females and 1 male). Two of the five cases presented with gastrointestinal bleeding with an ulcerative tumor, and the others only had epigastric discomfort. The tumors were located around the prepyloric antrum of the stomach. No definite diagnosis was reached before surgery in any of the five cases, and all of the tumors were considered likely to be benign lesions. Clinicians who treat such patients should be aware of this problem because of the difficulty in accurate preoperative diagnosis.

Glomus tumors closely resemble the normal glomus body and have a predilection for skin and subcutaneous tissue. These tumors rarely present in visceral organs. We report a case involving the kidney. This glomus tumor displays typical cytology and immunohistochemical profile of glomus tumors elsewhere. However, this tumor is large, has a deep location and exhibits an infiltrative margin and increased mitotic activity. These features, by current definition, would suggest malignant behavior. However, the rarity of such an entity in the kidney highlights the need for caution and a diagnosis in a continuum between benignity and malignancy. To the best of our knowledge, this report is the first case of infiltrating glomus tumor or glomus tumor of uncertain malignant potential arising in the kidney.

The glomus body is a neuromyovascular, arteriovenous structure primarily found in the skin and, less commonly, other organs, and is involved with thermoregulation. Neoplasms of the glomus organ are most commonly encountered in the skin and soft tissues of the extremities, particularly the subungual region. Glomus tumors are rare vascular neoplasms originating from the glomus body resulting from proliferation of modified muscle cells within this organ. Glomus tumors are commonly subdivided, based on the prominence of glomocytes, vascular structures, and smooth muscle cells, into solid glomus tumors (the most common variant), glomangioma, and glomangiomyoma. Previous reports of intrathoracic glomus tumors have shown that these tumors are most commonly encountered within the tracheobronchial tree or pulmonary parenchyma; mediastinal lesions are exceptionally rare. On the basis of imaging appearance of the glomangioma reported in this case as well as prior reports of tracheobronchial and pulmonary glomus tumors, mediastinal glomus tumors manifest as intensely enhancing masses with circumscribed or poorly defined margins, closely resembling thymic carcinoid tumor, pheochromocytoma, or hypervascular lymphadenopathy. Secretion of catecholamines and tracer uptake on Indium-111 octreotide scintigraphy, as seen in the present case, is probably exceptional. Because glomus tumors may be difficult to diagnose on routine histopathologic specimens, radiologists should be aware of this rare lesion and consider the diagnosis of glomus tumor when an intensely enhancing mediastinal mass is encountered.

Glomus tumor is a distinctive neoplasm characterized by the presence of cells that resemble the modified smooth muscle cells of the normal glomus body, which is a specialized form of arteriovenous anastomosis. We report a case of multiple subungual glomus tumors associated with neurofibromatosis and review the literature on the pathophysiology of this association.

OBJECTIVES Glomus tumors, a neoplasm arising from the glomus body, usually occur in the extremities with a particular predisposition to a subungual site. Glomus tumors are exceedingly rare in the external genitalia. In this case, the origin of a periurethral mass proved to be a glomus tumor. MATERIALS AND METHODS A 61-year-old woman presented with postmenopausal vaginal bleeding. Clinical examination revealed a focally ulcerating, soft periurethral mass. A subsequent wedge biopsy of a periurethral, submucosal tumor was examined microscopically using both hematoxylin and eosin stains and an extensive immunohistochemical panel. RESULTS The initial histopathologic differential diagnosis of the wedge biopsy included several neoplasms, but final analysis, including immunohistochemistry (vimentin, desmin, and calponin positivity), concluded that the lesion was a glomus tumor. CONCLUSIONS Periurethral masses are rare and may be caused by a large number of neoplastic and nonneoplastic lesions. This case of glomus tumor presenting as a periurethral mass may be the only third reported occurrence.

Glomic tumors are uncommon, painful, and usually benign hamartomas which often found on the fingertips. They arise from the normal glomus apparatus, located in the subcutaneous tissue. A glomus body is composed of an afferent arteriole, an anastomotic Suquet-Hoyer canal, an efferent venule, actin-containing glomus cells surrounding the canals, the intraglomerular reticulum, and a capsular portion [1]. The normal glomus body is a contractile neuromyoarterial receptor that controls blood pressure and temperature by regulating peripheral blood flow. Glomus bodies are present in the stratum reticularis of the dermis throughout the body. So, glomus tumors can occur in many parts of the body. We did not come across any case of glomus tumor at breast during our review of literature. Also, Bisceglia et al reported, at their review, that no glomus tumor either sporadic or in the context of any immunodeficiency has been recorded at breast [2]. Here, we present the first case.

Glomus tumor, also known as glomangioma, is a neoplasm derived from cells of the neuromyoarterial glomus or glomus body. We report a case of glomus tumor of the lung arising in the left lower lobe, incidentally found in a patient who underwent right bilobectomy for a carcinoma localized in the right upper lobe.

Six cases of locally aggressive and/or potentially malignant glomus tumors are described. On the basis of clinical and pathologic criteria, the following classification is proposed. The first category is a locally infiltrative glomus tumor (LIGT) which has the usual glomus histologic features. The second group is a cytologically malignant tumor arising and merging with a typical glomus tumor, designated glomangiosarcoma arising in a benign glomus (GABG). The third category and the most difficult to recognize is the de novo glomangiosarcoma (GADN), which must be distinguished from other round cell sarcomas. Most of these locally aggressive glomus tumors are vimentin positive and are immunoreactive for muscle-specific actin. Electron microscopic examination in one GABG case showed cells with numerous microfilaments and pinocytotic vesicles; a second GADN case contained cells with microfilaments and an incomplete basal lamina. As a group these locally aggressive or potentially malignant glomus tumors are larger and more deeply located than the conventional glomus tumor. Although 50% of these tumors recurred locally, none have metastasized.

Glomus tumors are thought to arise from specialized cells normally found within the glomus apparatus of the dermal stratum reticularis. We report the unusual occurrence of a glomus tumor from within a peripheral nerve. Previous investigators have suggested that the rare occurrence of glomus tumors in tissue where the glomus apparatus has not been described arise from ectopic glomus cells or differentiate from nonglomus cell sources. Many of the "ectopic" glomus tumors have been found in regions of extensive arteriovenous shunting such as in the digestive system and lung suggesting the presence of glomera at these locations. The finding of a glomus tumor within a peripheral nerve, a region where extensive arteriovenous shunting and glomus bodies have not been described, supports the occasional origin of a glomus tumor from a nonglomus cell source.

OBJECTIVE Glomus tumors are rare lesions that can arise intraosseously along the entire spinal axis. Only four cases have been reported, usually manifesting with severe back pain and involving the midthoracic spine or sacrum. The current report describes the largest such lesion reported in the literature to date and summarizes the clinical and pathological characteristics of these rare tumors. METHODS A single, recent case arising from the lumbar vertebra of L3 is described, and the literature of intraosseous spinal glomus tumors is reviewed. RESULTS The lesion described arose in a 44-year-old man with a 1-year history of neurological symptoms and a large dumbbell-shaped lesion involving the lumbar vertebra, which extended through the neural foramen at L3. The lesion was resected using a two-stage approach. Severe intraoperative hemorrhage necessitated emergent angiographic embolization. Histopathological examination confirmed the presence of a glomus tumor arising from the smooth muscle cells of the glomus body. CONCLUSION These rare lesions may extend into the epidural space and through the neural foramina and abdominal compartments; over time, they grow very large. Preoperative embolization may be indicated for large tumors suspected to be glomus tumors.

OBJECTIVE To review a large series of extradigital glomus tumors in order to gain a better understanding of their presentation and provide guidelines to aid in their diagnosis and treatment. PATIENTS AND METHODS We performed a retrospective review of all extradigital glomus tumors seen at our institution during a 20-year period (1985-2005) to document the incidence of the classic triad of symptoms, the duration of symptoms, the contribution of imaging to making a definitive diagnosis, and the effectiveness of treatment. RESULTS Fifty-six different patients with extradigital glomus tumors presented as follows: glomus tumors in the hand (3), wrist (4), forearm (11), elbow (4), arm (4), shoulder (2), buttock (1), thigh (5), knee (10), leg (3), ankle (2), foot (2), back (1), nose (1), cheek (1), ear lobe (1), and trachea (1). Forty-eight patients presented with pain and localized tenderness, but only 1 patient presented with cold intolerance. The average duration of symptoms was greater than 7 years, with most patients being evaluated previously and having their conditions misdiagnosed. Magnetic resonance imaging proved to be the most useful modality for localization of these lesions. Surgical resection was the definitive treatment and generally provided immediate and sustained pain relief. CONCLUSIONS Extradigital glomus tumors are not a rare subgroup of glomus tumors. Treatment outcomes are excellent, but misdiagnosis and delayed diagnosis are common. Improved guidelines regarding symptoms and diagnosis of these neoplasms may reduce the morbidity, ensuing chronic pain, and psychiatric consequences of delayed diagnosis or misdiagnosis.

Glomus tumors are benign lesions and originate from modified smooth muscle cells of the glomus body. These tumors are commonly observed in the dermis or subcutis, but only rarely found in the stomach. Here we report a case of a 67-year-old patient in whom glomus tumor of the stomach was diagnosed after 10-day history of melena. We have reviewed the 13 cases selected from literature of gastric glomus tumor in Korean, including our case. The age of onset ranged from 30 to 68 years (median 54 y) with a strong female dominance (10 females and 3 males). The tumors typically presented with gastrointestinal bleeding or ulcerlike symptom, and 6 tumors had mucosal ulceration. The tumor sizes varied from 1.2 to 3.8 cm (median 2.5 cm), and all tumors presented in antrum of stomach. Microscopically, the tumors were well-circumscribed, and composed of uniform, small, round to polygonal cells. Mitotic activity was usually low. The characteristics of gastric glomus tumors in Korean patients are very similar to those of Western populations. Although gastric glomus tumors can be considered more likely benign, a small possibility of malignant behavior cannot be ruled out.

Glomus tumors are uncommon, small, painful, and usually benign hamartomas arising from the arterial end of the glomus body. They often present early in the subungual stage because of intense pain. Two female patients with subungual glomus tumor are reported here. The intense pain associated with this tumor had led to disuse atrophy of the upper limb in one case. Hildreth's sign and Love's test were positive in both, but imaging did not help in preoperative diagnosis. Tumors were resected by transungual approach, leaving a 3-mm-wide margin. There was no recurrence after 1-year follow-up in both instances.

A case of multiple glomus tumors of the finger is presented, in which MRI was valuable in the diagnosis and preoperative tumor localization.

Glomus tumors are derived from the normal glomus body, which is an arteriovenous confluence involved with thermoregulation. These true glomus tumors are different from the "glomus tumors" derived from the paraganglion system often encountered by the otolaryngologist. Glomus tumors have been reported in a variety of locations including the pancreas, perineum, nasal cavity, and torso; however, most are found in the extremities. We present the first case of a laryngeal glomangiomyoma. Furthermore, this lesion was successfully excised endoscopically with a CO2 laser.

3Department of Pathology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. lomus tumors are mesenchymal tumors, arising from modified smooth-muscle cells of the glomus body, a type of neuromyoarterial receptor that is sensitive to variations in temperature and plays a role in the regulation of arteriolar blood flow [1]. Most of the tumors are located at the subungual regions of the fingertips, the palms, the wrists, and the toes. The tumors have also been reported in the gastrointestinal, urogenital, cardiovascular, and respiratory tracts and in the hepatobiliary system. In the gastrointestinal tract, they occur most often in the stomach. Glomus tumors of the stomach typically appear as a submucosal nodule or mass on the greater curvature side of the antrum. To our knowledge, there has been no previous report regarding the MRI features of a gastric glomus tumor, although the upper gastrointestinal series and CT features of the tumor have been described [2–4]. In combination with the tumor size, location and MR signal intensity can suggest the diagnosis of gastric glomus tumor.

Malignant glomus tumor (MGT) is a rare, recently described neoplasm that recapitulates the appearance of the modified smooth cells of the normal glomus body. We report a case of MGT of the hand of a 48-year-old woman. Magnetic resonance imaging (MRI) showed a 2.8-cm, well circumscribed, enhancing mass on the volar aspect of the thenar region of the right hand in immediate continuity with the ulnar artery and nerve. Computed tomography scan (CT-Scan) of the chest was normal. Histologic evaluation revealed a multilobular lesion with prominent branching capillary vasculature and perivascular arrangement of sheets of tumor cells. The tumor cells were round, relatively uniform in size with distinct cell borders and perinuclear cytoplasmic clearing. They were of intermediate to high nuclear grade and showed significant mitotic activity. A wide local excision with negative margins was performed. Multiple lung metastases were evident at 8-month follow-up. To date, forty-five cases of MGT of skin and soft issue have been reported in the literature. Twelve of the forty-five cases developed metastasis. In this report, we emphasize the differential diagnosis of MGT in the skin and deep soft tissue.

The glomangioma is one of a group of benign tumors of glomus body origin. Commonly found in the distal extremities, they may present with pain, tenderness to palpation, and sensitivity to temperature. Histologically, varying proportions of glomus cells, as well as vascular and smooth muscle elements, are found. Complete surgical excision is usually curative. We report on a glomangioma of the ankle in a 12-year-old male patient that simulated injury to the flexor hallucis longus tendon.