J Korean Soc Radiol.  2018 Aug;79(2):106-109. 10.3348/jksr.2018.79.2.106.

An Unusual Cause of Knee Pain: Periosteal Glomus Tumor of the Distal Femur

• Cho HJ
• Ahn KS
• Kang CH
• Kim Y
• Park JH

• KMID: 2416397
• DOI: http://doi.org/10.3348/jksr.2018.79.2.106

Abstract

Glomus tumors are rare neoplasms that characteristically occur in subungual regions, but may also be found in other regions of the body. The clinical diagnosis of this tumor may be difficult if the tumor is located in an extradigital site. Most extradigital glomus tumors form in superficial locations. Herein, we present the case of a 34-year-old woman who experienced chronic knee pain with pinpoint tenderness resulting from a deep-seated periosteal glomus tumor of the distal femur. Extradigital glomus tumors should be considered in the differential diagnosis when characteristic clinical features and imaging findings indicative of glomus tumors are present, even if the tumor is located within deep tissues.

MeSH Terms

Adult
Diagnosis
Diagnosis, Differential
Female
Femur*
Glomus Tumor*
Humans
Knee*
Magnetic Resonance Imaging
Periosteum
Ultrasonography

Figure

• 

  Fig. 1 Periosteal glomus tumor of the distal femur in a 34-year-old woman, complaining chronic knee pain with pinpoint tenderness. A–C. Axial T2-weighted fat-saturated (A), sagittal T1-weighted (B), and contrast agent-enhanced T1-weighted fat-saturated (C) magnetic resonance images of the left thigh show a 10-mm, well-circumscribed mass at the anteromedial aspect of the femoral cortex. The mass appeared hyperintense on T2-weighted images and isointense on T1-weighted images with homogeneous and vivid enhancement after contrast enhancement (arrows). D. Ultrasonographic image demonstrated a hypoechoic mass adjacent to the left femoral cortex. On color Doppler study, Doppler signal was not obvious. E. Pathological examination with hematoxylin and eosin staining (× 100) revealed that the tumor comprised solid sheets of glomus cells with multiple variable-sized vessels. F. Tumor cells show strong immunoreactivity for smooth muscle actin immunostaining (× 200).

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