Mediastinal Glomus Tumor: A Case Report and Literature Review

Abstract

A glomus tumor in the mediastinum is very uncommon, and only five cases have been reported in the English literature. We recently encountered a 21-year-old woman with an asymptomatic mediastinal mass that measured 5.3 × 4.0 cm. Surgical excision was performed, and the tumor was finally diagnosed as mediastinal glomus tumor with an uncertain malignant potential. After reviewing this case and previous reports, we analyzed the clinicopathologic features associated with progression of such a tumor.

Malignant Glomus Tumor of the Heart in a 64-Year Old Male Presenting with Stroke

“…7 They may appear asymptomatic 7 but typically presents with a characteristic clinical triad of pain, pinpoint tenderness and cold hypersensitivity. 4 Glomus tumors have also been reported in rare locations such as the respiratory tract, 3 mediastinum, 4 stomach, 5 vulva, 6 penis 7 and eye. 8 We describe a highly unusual case of a glomus tumor of the heart.…”

“…Deeply located glomus tumors, located in the visceral organs, including the heart, falls under malignant glomus tumor or glomus tumor of uncertain malignant potential. 4 Folpe et al, proposed a reclassification of malignant glomus tumor to include deep location and a size of more than 2 cm in addition to increased mitotic activity and nuclear atypia in its criteria. 12 Glomus tumor of uncertain malignant potential may only have one of the following: superficial location with increased mitotic activity (>5/50 hpf), or a size of >2 cm only, or deep location.…”

“…This can be categorized into four groups; malignant glomus tumor, glomus tumor of uncertain malignant potential, symplastic glomus tumor, and glomangiomatosis. 4 Malignant glomus tumors account to less than 20 cases 2 and shows features of severe atypia, increased mitotic activity (>5/50 hpf) or presence of atypical mitosis. Deeply located glomus tumors, located in the visceral organs, including the heart, falls under malignant glomus tumor or glomus tumor of uncertain malignant potential.…”

“…12 Glomus tumor of uncertain malignant potential may only have one of the following: superficial location with increased mitotic activity (>5/50 hpf), or a size of >2 cm only, or deep location. 4,12 Tumors with severe nuclear atypia but lacks criteria for malignant glomus tumor are classified under symplastic glomus tumor. Tumors with diffuse growth resembling angiomatosis with prominent glomus component but lacks criteria for malignant glomus tumor or glomus tumor of uncertain malignant potential are classified under glomangiomatosis.…”

“…1 They usually present as painful solitary or multicentric masses, most commonly located subungually and also occurs in the dermis or subcutis of the upper or lower extremity. 2 They are reported to also primarily arise in unusual locations such as the respiratory tract, 3 mediastinum, 4 stomach, 5 vulva, 6 penis, 7 and eye. 8 …”