Glomus Tumor of Digital Nerve — A Case Report

A glomus tumor is a soft tissue tumor that arises from the glomus body, a peripheral organ responsible for temperature regulation of the skin. It accounts for about 1% to 5% of tumors occurring in the hand, is mainly located in the subungal, and is less than 1 cm in size. Diagnosis is mainly based on clinical symptoms, and the main symptoms are pain at the site of glomus tumor, pinpoint tenderness, and cold intolerance. The pain is severe and usually requires surgical resection, and the results of treatment are good with complete resection of the tumor. In this case report, the patient is a 37-year-old female who developed pain in the radial side around the proximal interphalangeal joint of the right second finger without any traumatic history. On physical examination and imaging, it was diagnosed as a glomus tumor of the digital nerve and resected. After surgery, the symptoms improved and there was no recurrence. A careful examination and accurate diagnosis and treatment are necessary for symptomatic masses.

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Primary pancreatic glomus tumor invading into the superior mesenteric vein: a case report

Surgical Case Reports ◽

10.1186/s40792-020-01058-7 ◽

2020 ◽

Vol 6 (1) ◽

Author(s):

Ichiro Tamaki ◽

Yohei Hosoda ◽

Hironobu Sasano ◽

Yu Sasaki ◽

Hidenori Kiyochi ◽

...

Keyword(s):

Case Report ◽

Tumor Cells ◽

Solid Tumor ◽

Superior Mesenteric Vein ◽

Glomus Tumor ◽

Small Cells ◽

Histopathological Analysis ◽

Glomus Tumors ◽

Mesenteric Vein ◽

Direct Invasion

Abstract Background Glomus tumors are subcutaneous tumors arising from glomus bodies, thermoregulatory components of the skin. These tumors could occur in visceral organs where glomus bodies are not normally present. Herein, we report a case of primary pancreatic glomus tumor with aggressive direct invasion into the superior mesenteric vein (SMV). To the best of our knowledge, this is the second case report of a glomus tumor arising in the pancreas. Case presentation A 46-year-old woman was referred to our hospital due to vomiting with epigastric and back pain. Dynamic-CT revealed a well-circumscribed hypervascular mass, measuring 37 mm in its maximal diameter involving the pancreatic head. Both CT and endoscopic ultrasonography (EUS) revealed direct invasion into the SMV and radiologically suspected tumor thrombus. Biopsy sample obtained by EUS-guided fine needle aspiration revealed proliferation of small cells, round-to-oval tumor cells with round nuclei and scant cytoplasm. A histological diagnosis of pancreatic neuroendocrine tumor, G1 was initially considered. Therefore, subtotal stomach-preserving pancreatoduodenectomy using Child-II reconstruction was subsequently performed. Her SMV was resected and reconstructed due to extensive tumor involvement. Subsequent histopathological analysis revealed solid tumor cells proliferation that comprised oval-shaped nuclei and scant cytoplasm around disorganized or slit-shaped vessels in hematoxylin–eosin-stained slides. Immunohistochemical analysis then demonstrated positive immunoreactivity for smooth muscle actin, vimentin, and CD34, but negative for chromogranin A, synaptophysin, CD56, and signal transducer and activator of transcription 6. Based on these histological findings of resected specimens, the lesion was subsequently diagnosed as a primary pancreatic glomus tumor harboring direct invasion into the SMV. Her postoperative course was uneventful and annual surveys for the following 4 years post-op detected no clinical signs of recurrence. Conclusions We report a very rare case of glomus tumor of the pancreas accompanied by venous invasion. Curative surgical resection is the best treatment option for pancreatic glomus tumors. Although pancreatic glomus tumor is rare, it should be taken into consideration in the differential diagnosis of a pancreatic solid tumor with hypervascularity.

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