Symplastic glomus tumor

Abstract

Glomus tumors showing nuclear pleomorphism without any other malignant features have been defined as symplastic glomus tumors. This type of glomus tumor is rarely encountered. Another case of symplastic glomus tumor is described in this study. A 37-year-old woman referred to the hospital with the complaint of a palpable tender nodule on the fourth finger tip of her left hand. The lesion had been present for about a year and aggravation of tenderness upon cold exposure was conspicuous. It was a 0.5 cm well circumscribed lesion with round to cuboidal epithelioid cells showing high grade nuclear pleomorphism. nests of cells more uniform in shape and showing punched out nucleus representative of typical glomus tumor could also be observed. Immunohistochemical study showed expression of smooth muscle actin, caldesmon and vimentin. Ki-67 labeling index was undetectable. Investment of tumor cells was shown by type IV collagen. In contrast to its atypical cellular morphology, symplastic glomus tumor clinically behaves benign, and it is important to differentiate it from malignant glomus tumor as well as other primary or metastatic malignant tumors.

Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

“…Regarding the delay in diagnosis, defined as the time elapsed from the onset of symptoms to the definitive diagnosis, 22 articles mention this variable, with a maximum value of 50 years in 1 publication, 9 and a minimum of 6 months in 2, 12,15 although most of them (19 articles 10,12,[14][15][16][19][20][21][23][24][25][26][28][29][30]33,36,40 ) refer to periods from 1 to 10 years.…”

“…Regarding the clinical presentation as a tumor, 19 articles 1,8-10, [13][14][15]18,19,21,23,24,28,30,[32][33][34][35]40 describe its size with a variability from 1.8 mm to 26 mm, with a predominance of 10 mm or smaller, reported in 17 articles. 1,9,10,[13][14][15]18,19,21,23,28,30,[32][33][34][35]37…”

“…The initial clinical presentation with nail deformation is found in 15 articles, 1,9,11,15,19,20,[24][25][26][27]30,31,[34][35][36] is specified as absent in 10, while 5 articles don't mention it. 12,23,29,32,33…”

“…The classic clinical triad was reported with all its components in most cases (16 articles): the most frequent symptom was spontaneous pain, found in 24 articles, 1,8-10, [12][13][14][15][16][18][19][20][21][22][23]25,26,28,29,32,35,36,40 while only El Jouari et al 24 and Kallis et al 27 specified the absence of this symptom in their case reports.…”

Symplastic glomus tumor of the urinary bladder treated by robot-assisted partial cystectomy: a case report and literature review

“…Most glomus tumors are benign, but some cases with malignant/uncertain malignant potential have been documented (6). Furthermore, a form of glomus tumor that shows striking nuclear atypia without any other malignant features has been designated as symplastic glomus tumor (7). In contrast to its atypical cellular morphology, this tumor usually behaves benign from a clinical point of view, and it is important to differentiate it from malignant glomus tumor as well as other primary or metastatic malignant tumors.…”