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原文題目(出處)： Glomus tumor of the cheek: A case report. Case Reports in Medicine 2012, article ID 307294
原文作者姓名： KonstantinosVeros, KonstantinosMarkou, Chrysa Filitatzi, andDionysios E.Kyrmizakis
通訊作者學校： 1st Department of Otorhinolaryngology Head & Neck Surgery, AHEPA University Hospital, 54006 Thessaloniki, Greece
Department of Pathology, Department of Otorhinolaryngology Head & Neck Surgery, General Hospital of Veroia, 59100 Veroia, Greece
報告者姓名(組別)： 紀勝元 Intern L 組
報告日期： 2012/08/06
內文：
Introduction
* Glomus tumor:
- called paraganglioma
- benign neoplasm of perivasculature - 1~2% of soft tissue tumors
- 3% metastasis
- painful subcutaneous nodules in subungual area of digits - rare in cheek
- symptoms: pain ,localized tenderness, cold, Hypersensitivity Case report
* 24-year-old man with a four-year painful nodule in left cheek that reoccurred after two excisions in the last four months
* Clinical examination:
- well-defined ,round ,firm nodule - 1 x 1 cm
- subdermic
- without fixation to underlying tissues - painful on palpation
- normal oral cavity
- no neck lymph nodes be palpated
* Contrast enhanced CT:
- well-defined, round soft-tissue mass of left cheek over buccinator muscle
- measuring 13.8 x 9 mm
- a very small satellite lesion attached
口腔病理科 On-Line KMU Student Bulletin
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* After relatively wide excision, specimen was consistent with diagnosis of glomus tumor of the solid type, with no mention of potential residual disease
* Patient reported relief of symptoms after surgery
* 2-month follow-up :
- complained of gradual recurrence of local tenderness at the site of the excision
* Three months later :
- small palpable nodule and complete recurrence of symptoms
* Very wide excision performed :
- 1 cm margin around the previous scar
口腔病理科 On-Line KMU Student Bulletin
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Solid : Angiomatoid :
Angiomyomatous :
* Histological examination :
- margins of the excision were reported as free of lesion
* Patient remains without any symptoms nine months after surgery
* Glomus body:
- neuromyoarterial unit found within reticular dermis that serves as a specialized arteriovenous anastomosis
- arterial end of glomus body(Sucquet-Hoyer) surrounded by modified smooth muscle cells
called glomus cells →regulate blood flow to skin in response to temperature changes
* Variantts of glomus tumor
1. Solid: poor vasculature, scant smooth muscle component 2. Angiomatoid(Glomangioma): predominant vascular component
3. Glomangiomyoma: prominent vasculature and smooth muscle components
* Glomus tumors:
- Mostly solitary masses
- Malignant transformation extremely rare (3%)
- Most commonly in upper extremity , especially in subungual area - Facial location , especially in cheek is rare
Discussion
* Facial glomus tumor:
- asymptomatic subcutaneous nodule rarely - may be excruciating chronic facial pain
- long history of consultations by various specialists
口腔病理科 On-Line KMU Student Bulletin
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without a definite diagnosis can be expected - pain , localized tenderness
- cold hypersensitivity may or may not
- 4:1 male predominance(extradigital glomus tumor)
* MRI the most sensitive imaging modality for diagnosis
Contrast enhanced CT aid in differential diagnosis and delineating anatomic relations for operation
* Small size and subcutaneous location → complete removal treatment as choice
* Excellent results anticipated - recurrence rates (12%~33%)
題號 題目
1 What’s location does glomus tumor mostly occur ? (A) Upper Extremity
(B) Lower extremity (C) Abdomen (D) thorax 答 案
( A)
出處：
Glomus Tumor of the Cheek: A Case Report KonstantinosVeros, KonstantinosMarkou, Chrysa Filitatzi, Dionysios E.Kyrmizakis. Hindawi Publishing Corporation Case Reports in Medicine Volume 2012, Article ID 307294, doi:10.1155/2012/307294
題號 題目
2 What percentage of all soft tissue tumors does glomus tumor account for ? (A) 20%~25%
(B) 35%~37%
(C) 8%~10%
(D) 1%~2%
答 案 (D )
出處：
Glomus Tumor of the Cheek: A Case Report
KonstantinosVeros, KonstantinosMarkou, Chrysa Filitatzi, Dionysios E.
Kyrmizakis. Hindawi Publishing Corporation Case Reports in Medicine Volume 2012, Article ID 307294, doi:10.1155/2012/307294
