Malignant Glomus Tumour: A Case Report and Review of the Literature

[摘要] Purpose:Glomus tumours are characteristically benign solitary tumours. At our knowledge, about 23 reports are present inliterature regarding the malignant counterpart, but only a minority developed metastases. We describe a locally aggressiveglomus tumour with lymphnode metastasis.Patient:The patient was a 40 year-old man presenting a 1.5-cm lesion on the right wrist incompletely excised and a recurrenttumour, 4 × 2 cm in size, removed after 9 months, for which he received radiotherapy. After 2 years he developed an axillarylymphnode metastasis.Results:Histologically, both tumours (primary and metastasis) were similar. There were sheets and nests of uniform smallcells with scant eosinophilic cytoplasm and round to polygonal nuclei; there was some degree of pleomorphism and themitotic index was high (up to 18 m/10 HPF). The tumour cells were positive for vimentin and smooth muscle actin, butnegative for desmin, NSE, Factor VIII, chromogranin, cytokeratin. Remarkably, in the primary, the cells strongly expressedp53 (70%) and MIB-1 (35%).Discussions:In many reported malignant cases, the histology of the tumour cells suggested that they were malignant, yet theclinical course has been benign. Carefully reviewing the literature, it seems that actually we have enough histological criteriato identify the cases with biological adverse outcome. Those unfortunate cases behave as high grade sarcomas and thereforemay deserve an aggressive therapeutic treatment.

[学科分类] 肿瘤学