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Glomus tumor of uncertain malignant potential of the brachial plexus: A case report

BACKGROUND: Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusua...

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Autores principales: Thanindratarn, Pichaya, Chobpenthai, Thanapon, Phorkhar, Termphong, Nelson, Scott D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789403/
https://www.ncbi.nlm.nih.gov/pubmed/31616697
http://dx.doi.org/10.12998/wjcc.v7.i18.2815
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author Thanindratarn, Pichaya
Chobpenthai, Thanapon
Phorkhar, Termphong
Nelson, Scott D
author_facet Thanindratarn, Pichaya
Chobpenthai, Thanapon
Phorkhar, Termphong
Nelson, Scott D
author_sort Thanindratarn, Pichaya
collection PubMed
description BACKGROUND: Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusual features can be occasionally found, leading to distinctive malignant potential required different therapeutic approaches. Glomus tumor of uncertain malignant potential is one type of atypical glomus tumor with limited criteria for malignancy and without metastasis. CASE SUMMARY: Herein, we report a case of a 48-year-old Thai male with a large painful mass in his axilla for one year without apparent neurological deficit. Magnetic resonance imaging showed a large heterogeneous mass encasing entire posterior cord of left brachial plexus and axillary artery. The tumor tissue from core needle biopsy histologically demonstrated the sheets and cords of relatively uniform tumor cells with foamy cytoplasm and round to oval hyperchromatic nuclei without atypia. The mitotic count was 0 per 50 high power field. A final diagnosis of glomus tumor of uncertain malignant potential was rendered. Complete surgical resection was performed, followed by adjuvant radiation due to positive margin. Neither local recurrence nor distant metastasis was observed at 2-year follow up. Unfortunately, postoperative incomplete brachial plexopathy without signs of re-innervation by electromyography was persisted. Later nerve grafting reconstruction was performed, followed by ongoing neurological rehabilitation. CONCLUSION: Glomus tumor of uncertain malignant potential is exceedingly rare, especially around brachial plexus. Although the prognosis is good, careful histological diagnosis and treatment are needed to achieve an optimal outcome with lower morbidity.
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spelling pubmed-67894032019-10-15 Glomus tumor of uncertain malignant potential of the brachial plexus: A case report Thanindratarn, Pichaya Chobpenthai, Thanapon Phorkhar, Termphong Nelson, Scott D World J Clin Cases Case Report BACKGROUND: Glomus tumor is an uncommon benign tumor usually presenting with a small mass occurring in the dermis or soft tissue of an extremity, especially subungual region. However, intraneural glomus tumor is sporadic. While most of the glomus tumors are benign, atypical glomus tumors with unusual features can be occasionally found, leading to distinctive malignant potential required different therapeutic approaches. Glomus tumor of uncertain malignant potential is one type of atypical glomus tumor with limited criteria for malignancy and without metastasis. CASE SUMMARY: Herein, we report a case of a 48-year-old Thai male with a large painful mass in his axilla for one year without apparent neurological deficit. Magnetic resonance imaging showed a large heterogeneous mass encasing entire posterior cord of left brachial plexus and axillary artery. The tumor tissue from core needle biopsy histologically demonstrated the sheets and cords of relatively uniform tumor cells with foamy cytoplasm and round to oval hyperchromatic nuclei without atypia. The mitotic count was 0 per 50 high power field. A final diagnosis of glomus tumor of uncertain malignant potential was rendered. Complete surgical resection was performed, followed by adjuvant radiation due to positive margin. Neither local recurrence nor distant metastasis was observed at 2-year follow up. Unfortunately, postoperative incomplete brachial plexopathy without signs of re-innervation by electromyography was persisted. Later nerve grafting reconstruction was performed, followed by ongoing neurological rehabilitation. CONCLUSION: Glomus tumor of uncertain malignant potential is exceedingly rare, especially around brachial plexus. Although the prognosis is good, careful histological diagnosis and treatment are needed to achieve an optimal outcome with lower morbidity. Baishideng Publishing Group Inc 2019-09-26 2019-09-26 /pmc/articles/PMC6789403/ /pubmed/31616697 http://dx.doi.org/10.12998/wjcc.v7.i18.2815 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Thanindratarn, Pichaya
Chobpenthai, Thanapon
Phorkhar, Termphong
Nelson, Scott D
Glomus tumor of uncertain malignant potential of the brachial plexus: A case report
title Glomus tumor of uncertain malignant potential of the brachial plexus: A case report
title_full Glomus tumor of uncertain malignant potential of the brachial plexus: A case report
title_fullStr Glomus tumor of uncertain malignant potential of the brachial plexus: A case report
title_full_unstemmed Glomus tumor of uncertain malignant potential of the brachial plexus: A case report
title_short Glomus tumor of uncertain malignant potential of the brachial plexus: A case report
title_sort glomus tumor of uncertain malignant potential of the brachial plexus: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789403/
https://www.ncbi.nlm.nih.gov/pubmed/31616697
http://dx.doi.org/10.12998/wjcc.v7.i18.2815
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