Glomus tumor natural history: Difference between revisions

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{{Glomus tumor}}
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==Overview==
==Overview==
If left untreated, patients with glomus tumors may progress to develop pain and nail discoloration. A common complication of the glomus tumor is [[malignant]] change in multiple tumors. Common complications of glomus tumors post operatively include nail deformities and recurrence. [[Prognosis]] is generally excellent for solitary glomus tumors and [[malignant]] glomus tumors treated with wide excision. However, the prognosis is poor for [[malignant]] glomus tumors with widespread [[metastases]].


==Prognosis==
==Natural History==
The most common adverse effect is pain, which is usually associated with solitary lesions. Multiple tumors are less likely to be painful. In one report, a patient with more than 400 glomus tumors had thrombocytopenia as a result of platelet sequestration (ie, Kasabach-Merritt syndrome). Malignant glomus tumors, or glomangiosarcomas, are extremely rare and usually represent a locally infiltrative malignancy. However, metastases do occur and are usually fatal.
If left untreated, patients with glomus tumors may progress to develop pain and nail discoloration.<ref name="pmid24470715">{{cite journal| author=Grover C, Khurana A, Jain R, Rathi V| title=Transungual surgical excision of subungual glomus tumour. | journal=J Cutan Aesthet Surg | year= 2013 | volume= 6 | issue= 4 | pages= 196-203 | pmid=24470715 | doi=10.4103/0974-2077.123401 | pmc=PMC3884883 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24470715  }} </ref>


Patients who have surgery or radiation tend to do well.
==Complications==
*A common complication of the glomus tumor is [[malignant]] change in multiple glomus tumors (glomangiosarcomas).
**Very rare and usually only locally invasive
**Widespread [[metastases]] may occur which are fatal
*Common complications of glomus tumors post operatively include:<ref name="pmid24470715">{{cite journal| author=Grover C, Khurana A, Jain R, Rathi V| title=Transungual surgical excision of subungual glomus tumour. | journal=J Cutan Aesthet Surg | year= 2013 | volume= 6 | issue= 4 | pages= 196-203 | pmid=24470715 | doi=10.4103/0974-2077.123401 | pmc=PMC3884883 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24470715  }} </ref>
**Nail deformity
**Recurrence
***Recurrence is thought to be a result of incomplete excision or, in the case of late recurrence, development of a new lesion at or near the excision site. Excision of the [[capsule]] of the tumor is required to prevent local recurrence.<ref name="pmid18997858">{{cite journal| author=Hazani R, Houle JM, Kasdan ML, Wilhelmi BJ| title=Glomus tumors of the hand. | journal=Eplasty | year= 2008 | volume= 8 | issue=  | pages= e48 | pmid=18997858 | doi= | pmc=PMC2567120 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18997858  }} </ref>
* Glomus tumors may recur locally:<ref name="pmid11145243">{{cite journal| author=Folpe AL, Fanburg-Smith JC, Miettinen M, Weiss SW| title=Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors. | journal=Am J Surg Pathol | year= 2001 | volume= 25 | issue= 1 | pages= 1-12 | pmid=11145243 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11145243  }}</ref>
** 10% of cases
** Usually infiltrative lesions
* Malignant glomus tumors are exceptional and include:<ref name="pmid111452432">{{cite journal| author=Folpe AL, Fanburg-Smith JC, Miettinen M, Weiss SW| title=Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors. | journal=Am J Surg Pathol | year= 2001 | volume= 25 | issue= 1 | pages= 1-12 | pmid=11145243 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11145243  }}</ref>
** Glomus tumors showing marked nuclear atypia along with any mitotic activity
** Glomus tumors containing atypical mitotic figures


==Complications==
==Prognosis==
The most common complications are due to nerve damage, which may be caused by the tumor itself or damage during surgery. Nerve damage can lead to:
Prognosis is generally excellent for solitary glomus tumors and [[malignant]] glomus tumors treated with wide excision.  


*Change in voice
However, the prognosis is poor for [[malignant]] glomus tumors with widespread [[metastases]].<ref name="pmid20322052">{{cite journal| author=Blanchard AJ| title=The Pathology of Glomus Tumours. | journal=Can Med Assoc J | year= 1941 | volume= 44 | issue= 4 | pages= 357-60 | pmid=20322052 | doi= | pmc=PMC1827043 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20322052  }} </ref>
*Difficulty swallowing
*Hearing loss
*Paralysis of the face


==References==
==References==
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Latest revision as of 19:17, 13 May 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]

Overview

If left untreated, patients with glomus tumors may progress to develop pain and nail discoloration. A common complication of the glomus tumor is malignant change in multiple tumors. Common complications of glomus tumors post operatively include nail deformities and recurrence. Prognosis is generally excellent for solitary glomus tumors and malignant glomus tumors treated with wide excision. However, the prognosis is poor for malignant glomus tumors with widespread metastases.

Natural History

If left untreated, patients with glomus tumors may progress to develop pain and nail discoloration.[1]

Complications

  • A common complication of the glomus tumor is malignant change in multiple glomus tumors (glomangiosarcomas).
    • Very rare and usually only locally invasive
    • Widespread metastases may occur which are fatal
  • Common complications of glomus tumors post operatively include:[1]
    • Nail deformity
    • Recurrence
      • Recurrence is thought to be a result of incomplete excision or, in the case of late recurrence, development of a new lesion at or near the excision site. Excision of the capsule of the tumor is required to prevent local recurrence.[2]
  • Glomus tumors may recur locally:[3]
    • 10% of cases
    • Usually infiltrative lesions
  • Malignant glomus tumors are exceptional and include:[4]
    • Glomus tumors showing marked nuclear atypia along with any mitotic activity
    • Glomus tumors containing atypical mitotic figures

Prognosis

Prognosis is generally excellent for solitary glomus tumors and malignant glomus tumors treated with wide excision.

However, the prognosis is poor for malignant glomus tumors with widespread metastases.[5]

References

  1. ↑ 1.0 1.1 Grover C, Khurana A, Jain R, Rathi V (2013). "Transungual surgical excision of subungual glomus tumour". J Cutan Aesthet Surg. 6 (4): 196–203. doi:10.4103/0974-2077.123401. PMC 3884883. PMID 24470715.
  2. ↑ Hazani R, Houle JM, Kasdan ML, Wilhelmi BJ (2008). "Glomus tumors of the hand". Eplasty. 8: e48. PMC 2567120. PMID 18997858.
  3. ↑ Folpe AL, Fanburg-Smith JC, Miettinen M, Weiss SW (2001). "Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors". Am J Surg Pathol. 25 (1): 1–12. PMID 11145243.
  4. ↑ Folpe AL, Fanburg-Smith JC, Miettinen M, Weiss SW (2001). "Atypical and malignant glomus tumors: analysis of 52 cases, with a proposal for the reclassification of glomus tumors". Am J Surg Pathol. 25 (1): 1–12. PMID 11145243.
  5. ↑ Blanchard AJ (1941). "The Pathology of Glomus Tumours". Can Med Assoc J. 44 (4): 357–60. PMC 1827043. PMID 20322052.


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