J Korean Neurosurg Soc.  2013 Dec;54(6):540-543. 10.3340/jkns.2013.54.6.540.

Glomus Tumor in the Femoral Nerve

• Park DS
• Choe WJ
• Chun YI
• Moon CT

• KMID: 2190956
• DOI: http://doi.org/10.3340/jkns.2013.54.6.540

Abstract

The glomus tumor of the peripheral nerve is one of the mesenchymal tumors originating in the epineurium, and is extremely rare. A 56-year-old man presented complaining of lancinating pain on the left thigh, which was provoked by pressure or exercise. Subsequent image study revealed a mass in the femoral nerve. Total surgical excision with the aid of intraoperative ultrasonography was performed and the pain was successfully controlled. The authors report an unusual case of a patient diagnosed with glomus tumor in peripheral nerve, with a review of the clinical features, imaging, and pathological findings.

Keyword

Glomus tumor; Peripheral nerve; Femoral nerve

MeSH Terms

Femoral Nerve*
Glomus Tumor*
Humans
Middle Aged
Peripheral Nerves
Thigh
Ultrasonography

Figure

• 

  Fig. 1 MRI shows a 2.5 cm sized well-defined enhancing mass (arrowhead) in the femoral nerve among rectus femoris, vastus lateralis and vastus intermedius at mid-thigh level.

• 

  Fig. 2 Intraoperative ultrasonography (USG) showing an oval hypoechoic mass. With the aid of intraoperative USG, the deep seated tumor could be located exactly.

• 

  Fig. 3 Operative view of the glomus tumor (inside the circle) : oval in shape with moderate vascularity, and well demarcated with the nerve. The tumor was removed without difficulty using microscopic technique. The tumor was connected to a vessel.

• 

  Fig. 4 A : H&E, original magnification ×200. Cells are round, uniform and basophilic. Rich cytoplasm and centrally placed nucleus are observed. Dilated vessels are surrounded by tumor cells. B, C and D : Original magnification ×200. Tumor cells are positive for smooth muscle antigen; SMA (B), negative for S-100 protein (C), and showing low Ki-67 proliferative index less than 1.0% (D). SMA : smooth muscle antigen.

Reference

1. Calonje E, Fletcher CD. Cutaneous intraneural glomus tumor. Am J Dermatopathol. 1995; 17:395–398. PMID: 8600806.

2. Donato G, Iofrida G, Amorosi A. Images in pathology. Glomangioma of the sural nerve. Int J Surg Pathol. 2006; 14:332–333. PMID: 17041200.

3. Fitzpatrick TB, Freedberg IM. Fitzpatrick's dermatology in general medicine, ed 6. New York: McGraw-Hill;2003.

4. Folpe AL, Fanburg-Smith JC, Miettinen M, Weiss SW. Atypical and malignant glomus tumors : analysis of 52 cases, with a proposal for the reclassification of glomus tumors. Am J Surg Pathol. 2001; 25:1–12. PMID: 11145243.

5. Gombos Z, Zhang PJ. Glomus tumor. Arch Pathol Lab Med. 2008; 132:1448–1452. PMID: 18788860.

6. Khoury T, Balos L, McGrath B, Wong MK, Cheney RT, Tan D. Malignant glomus tumor : a case report and review of literature, focusing on its clinicopathologic features and immunohistochemical profile. Am J Dermatopathol. 2005; 27:428–431. PMID: 16148414.

7. Kline SC, Moore JR, deMente SH. Glomus tumor originating within a digital nerve. J Hand Surg Am. 1990; 15:98–101. PMID: 2153724.

8. Rodríguez-Justo M, Aramburu-González JA, Santonja C. Glomangiosarcoma of abdominal wall. Virchows Arch. 2001; 438:418–420. PMID: 11355180.

9. Scheithauer BW, Rodriguez FJ, Spinner RJ, Dyck PJ, Salem A, Edelman FL, et al. Glomus tumor and glomangioma of the nerve. Report of two cases. J Neurosurg. 2008; 108:348–356. PMID: 18240933.

10. Scheithauer BW, Woodruff JM, Erlandson RA. Tumors of peripheral nervous system. In : Rosai J, Sobin LH, editors. Atlas of Tumor Pathology, Third Series, Fascicle 24. Washington: Armed Forces Institute of Pathology;1999.

11. Shin DK, Kim MS, Kim SW, Kim SH. A painful glomus tumor on the pulp of the distal phalanx. J Korean Neurosurg Soc. 2010; 48:185–187. PMID: 20856673.

12. Shugart RR, Soule EH, Johnson EW Jr. Glomus tumor. Surg Gynecol Obstet. 1963; 117:334–340. PMID: 14080348.

13. Smith KA, Mackinnon SE, Macauley RJ, Mailis A. Glomus tumor originating in the radial nerve : a case report. J Hand Surg Am. 1992; 17:665–667. PMID: 1321179.

14. Taraszewska A, Kroh H, Bojarski P. [Light microscopic and ultrastructural features of nerve fibres in glomus tumor in two patients with long-term pain]. Neurol Neurochir Pol. 2000; 34:791–799. [Article in Polish]. PMID: 11105311.

15. Tropet Y, Menez D, Billerey C, Vichard P. [Glomus tumor of the sciatic nerve]. Ann Chir Plast Esthet. 1991; 36:204–208. PMID: 1721776.

16. Wing H, Leavitt L. Electrodiagnosis and electromyography in two unusual clinical syndromes (glomus tumor of common peroneal nerve and vasculitis of thoracolumbar portion of the spinal cord). Arch Phys Med Rehabil. 1962; 43:249–253. PMID: 14007480.