CASE REPORT

Year: 2017 I Volume: 1 I Issue: 1 I Page: 39-40

Isolated extra digital glomus tumor over abdomen

1Department of Dermatology, Venereology and Leprosy, SMS Medical College and associated group of Hospitals, Jaipur, Rajasthan, India.

Corresponding Author:
Dr. Surendra kumar,
S 175, Mahaveer Nagar, Gopalpura Mod,
Tonk Road, Jaipur.
Email: surenbhu2001@gmail.com

Abstract:

A 40-year-old male presented to our hospital with a painful nodular lesion over the abdomen since three months. Patient complained of excruciating pain over the lesion on manipulation and physical activity and even on respiration. Excisional biopsy was done. Diagnosis was considered on histopathological grounds.

How to cite this article:
Dangi S, Kumar S, Mehta T, Agarwal US. Isolated extradigital glomus tumor on abdomen. Indian Journal of Clinical Dermatology 2017;1:39-40.

Background:

We are reporting a case of an extradigital glomus tumor arising in the subcutaneous tissue of the abdomen. Glomus tumor is a hamartoma or a neoplasm of neuromyoarterial glomus, which plays an important role in temperature regulation. Most common site is distal extrimities, particularly subungal digital region. Extradigital tumors are unusual. We were not able to find an isolated extra digital glomus tumor on abdomen even after extensive Medline based literature search, so we are reporting this case for its rarity.

Case Presentation:

A 40-year-old male presented to our hospital with a painful nodular lesion over the abdomen since three months. Patient complained of excruciating pain over the lesion on manipulation and physical activity and even on respiration. There was no history of preceding trauma. Cutaneous examination of the affected area revealed a single brownish nodule of about 1.5 x 1 cm in size on the abdomen approximately in right midclavicular line [Figure 1].

Figure 1: Single brownish nodule over abdomen in right midclavicular line (encircled).

Click here to view

The nodule was firm in consistency and was tender. Mass was excised following a clinical diagnosis of infected sebaceous cyst. Histopathological examination of the excised nodule revealed a non epithelial neoplasm in deep dermis, made up of irregular vascular channels which showed within their walls monomorphous rounded cells with abundant pink cytoplasm and monomorphous oval nuclei. Most of the neoplasm was surrounded by a thin layer of fibrous tissue [Figure 2 and 3]. These histopathological findings are diagnostic of glomus tumor.

Figure 2: Histopathology showing stratified squamous lining with well circumscribed tumour in the dermis (H and E, x10)

Click here to view
Figure 3: Histopathology showing the tumour consisting of irregular vascular channels lined by monomorphous rounded cells with abundant pink cytoplasm and monomorphous oval nuclei (H and E, x 40)

Click here to view

Discussion:

Glomus tumor is a hamartoma or a neoplasm of neuromyoarterial glomus, which plays an important role in temperature regulation. They constitute 1.6% of all soft tissue tumors.1 Under normal conditions a glomus body acts to regulate blood flow to the skin and plays an important role in temperature regulation. Glomus tumors may be solitary or multiple. Subungual glomus tumors are more common in females & female to male ratio is 2:1.2 Extra digital glomus tumors are more common in males as in our case too.3 The commonest site is fingers, followed by other sites on the extremities including the head, neck and penis.3 There have been reports in the literature of unusual location of glomus tumor such as ankle, foot, knee, thigh and hip.4 In this case we report extradigital glomus tumor of abdomen. Solitary Glomus tumor should be differentiated from the painful tumors of the skin such as eccrine spiradenoma and leiomyoma. In these cases there are two populations of cells and focal ductal differentiation is seen.5

Surgical excision is the treatment of choice for isolated tumor. It is usually curative but rarely local recurrence occurs in case of incomplete excision. With multiple tumors on the extremities sclerotherapy with sodium tetra decyl sulphate, polidocinol and hypertonic saline has been reported to be effective. In our case we referred the patient to general surgery for complete excisison.

Thus to conclude, in case of any tender nodule over abdomen, we should keep the differential diagnosis of leiomyoma, eccrine spiradenoma and extradigital glomus tumor.

References:

1. Shugart RR, Soule EH, Johnson EW Jr. Glomus Tumor. Surg Gynecol Obstet 1963;117:33440.

2. Shivaswamy KN, Thappa DM, Jayanthi S. A solitary painful nodule. Indian J Dermatol Venereol Leprol 2003;69:35960.

3. Schiefer TK, Parker WL, Anakwenze OA et al. Extradigital glomus tumors: a 20-year experience. Mayo Clin Proc 2006;81:133744.

4. Rao AG, Indra D, Kamal J. Extra digital glomangioma. Indian J Dermatol 2010;55:3978.

5. Calonge E. Soft tissue Tumours and Tumour like conditions. In : Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook's Textbook of Dermatology. 8th ed. Oxford: Wiley-Blackwell; 2010.p.56.2-56.62



Top