Bali Gurvinder Singh, Hartman Douglas J, Haight Joel B, Gibson Michael K
University Hospitals Case Medical Center, Seidman Cancer Center, Case Western Reserve University, 11100 Euclid Avenue, LKS 5079, Cleveland, OH 44106, USA.
Division of Anatomic Pathology, Department of Pathology, University of Pittsburgh Medical Center, 200 Lothrop Street A610, Pittsburgh, PA 15213, USA.
Case Rep Oncol Med. 2013;2013:287078. doi: 10.1155/2013/287078. Epub 2013 Dec 17.
Glomus tumors are rare neoplasms that usually occur on the hands in a subungual location, or sometimes in palms, wrists or soles of the feet. They are described as purple/pink tiny painful lesions with a triad of pain, local point tenderness, and cold hypersensitivity. They are almost always benign, but rare malignant variants have been reported. They have also been reported to be present at unusual locations, like the lung, stomach, or liver. Gastrointestinal glomus tumors are extremely rare tumors and very few cases have been reported in the literature. Most that have been reported were usually benign in nature. A rare esophageal glomangioma, mimicking a papilloma, was reported in 2006. We report a case of glomangiosarcoma (malignant glomus tumor) in a 49-year-old female, who presented with symptoms of dysphagia including some spasm and hoarseness and subjective unintentional weight loss. On endoscopic exam, she was found to have a distal esophageal mass with malignant features. Radiologically, the mass had a size of about 8 cm on the CT scan without evidence of metastases. Pathology and immunostaining of the biopsy showed features resembling a malignant glomus tumor. She underwent an endoscopic and laparoscopic staging of the tumor along with ultrasound. Based on the laparoscopic findings, which were consistent with the preoperative diagnosis, she was scheduled for an esophagectomy. Histopathology and immunophenotypic features of the excised mass were consistent with a diagnosis of malignant glomus tumor.
血管球瘤是一种罕见的肿瘤,通常发生于手部指甲下的位置,有时也出现在手掌、手腕或脚底。它们被描述为紫色/粉色的微小疼痛性病变,具有疼痛、局部压痛和冷过敏三联征。它们几乎都是良性的,但也有罕见的恶性变体的报道。它们也被报道出现在不寻常的部位,如肺、胃或肝脏。胃肠道血管球瘤是极其罕见的肿瘤,文献中报道的病例很少。大多数报道的病例本质上通常是良性的。2006年报道了一例罕见的模仿乳头状瘤的食管血管球瘤。我们报告一例49岁女性的血管球肉瘤(恶性血管球瘤),她表现出吞咽困难的症状,包括一些痉挛和声音嘶哑以及主观上的非故意体重减轻。在内镜检查中,发现她有一个具有恶性特征的食管远端肿块。放射学检查显示,CT扫描上该肿块大小约为8厘米,无转移迹象。活检的病理和免疫染色显示出类似恶性血管球瘤的特征。她接受了肿瘤的内镜和腹腔镜分期检查以及超声检查。基于与术前诊断一致的腹腔镜检查结果,她被安排进行食管切除术。切除肿块的组织病理学和免疫表型特征与恶性血管球瘤的诊断一致。