Glomus Tumor - Vascular pathology Usmle step 1

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12/07/23

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Glomus Tumor - Vascular pathology Usmle step 1

Glomus tumor is a rare, benign neoplasm composed of cells resembling the modified smooth muscle cells of the normal glomus body . It is usually located in areas of the skin that are rich in glomus bodies (eg, the subungual regions of digits or the deep dermis of the palm, wrist, forearm, and foot). Glomus tumors of the fingers and toes occur in approximately 5 percent of patients with neurofibromatosis type 1 (NF1) and are considered NF1-associated neoplasms

Glomus tumor presents as a pink or purple vascular papule or nodule associated with paroxysmal pain, cold sensitivity, and tenderness. Subungual glomus tumors are particularly painful. Nail dystrophy and/or a bluish-red flush are typically seen

The diagnosis is suspected on the basis of the clinical appearance and history of paroxysmal pain and cold sensitivity. Histopathologic examination of the excised tumor is necessary to confirm the diagnosis.

Histologically, glomus tumor is a well-circumscribed dermal nodule composed of glomus cells, vasculature, and smooth muscle cells . Solid glomus tumor, with scarce vasculature and scant muscle component, is the most common variant . Less common variants include glomangioma, with prominent vascular component, and glomangiomyoma, with prominent vascular and smooth muscle components.

Treatment is surgical excision. For subungual tumors, preoperative imaging studies with color Doppler ultrasonography and magnetic resonance may provide information on tumor size, shape, and precise anatomic location
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