glomus tumor

血管球瘤
  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    背景:恶性胃血管球瘤(GGT)是一种极其罕见的间充质起源的恶性肿瘤,它影响病人的健康,甚至威胁生命。在没有预后研究的现有文献中,甚至很少报道具有血管侵袭的恶性GGT。所以,在这种情况下,我们报道了1例恶性GGT伴血管侵犯,并进行了5年的术后随访.据我们所知,我们报告了首例恶性GGT伴血管侵犯,术后5年无复发。这为恶性GGT伴血管侵犯的治疗提供了实例和教训。
    方法:一名49岁男性因健康检查发现胆囊结石入院。在完成腹部CT和超声胃镜检查后,发现胃窦有肿块。
    方法:术后病理结合SMA免疫组化阳性确诊为恶性GGT,波形蛋白,突触素,H-Caldesmon,还有Calponin,有丝分裂>10/50HPF和中度至重度核异型。
    方法:在住院的第6天,患者接受了腹腔镜远端胃切除术和胆囊切除术。
    结果:患者术后1周顺利出院,随访5年无复发。
    结论:恶性GGT可以是无症状的。对于无远处转移的恶性GGT,尽管有血管侵犯,阴性切缘手术仍可作为标准的手术根治性治疗方法。
    BACKGROUND: Malignant gastric glomus tumor (GGT) is an extremely rare malignant tumor of mesenchymal origin, it affects the patient\'s health and even threatens life. Malignant GGT with vascular invasion is even more rarely reported in the available literature without a prognostic study. So, in this case, we report a malignant GGT with vascular invasion and performed a 5-year postoperative follow-up. To the best of our knowledge, we report the first case of malignant GGT with vascular invasion without recurrence 5 years after surgery. This provides examples and lessons for the treatment of malignant GGT with vascular invasion.
    METHODS: A 49-year-old male was admitted to the hospital with gallbladder stones found on health check. After completing abdominal CT and ultrasound gastroscopy, a mass in the gastric antrum was found.
    METHODS: The diagnosis of malignant GGT was confirmed by combination of postoperative pathology with positive immunohistochemistry for SMA, vimentin, synaptophysin, H-caldesmon, and calponin, mitosis > 10/50 HPF and moderate-to-severe nuclear atypia.
    METHODS: On the 6th day of hospitalization, the patient underwent laparoscopic distal gastrectomy and cholecystectomy.
    RESULTS: The patient was discharged successfully 1 week after surgery and was followed up for 5 years without recurrence.
    CONCLUSIONS: Malignant GGT can be asymptomatic. For malignant GGT without distant metastasis, despite the presence of vascular invasion, negative margin surgery can still be the standard surgical radical treatment.
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  • 文章类型: Journal Article
    指甲血管球瘤是一种众所周知的肿瘤,具有明确的临床特征和手术治疗;然而,其中一些病变发生在不同的位置和大小,手术很难解决。
    临床和影像学检查有助于肿瘤的诊断和定位。
    对这些病例有足够的外科知识可确保较低的复发率和指甲营养不良。
    UNASSIGNED: Nail glomus tumor is a well-known tumor, with well-defined clinical characteristics and surgical treatment; however, some of these lesions occur in different locations and sizes with difficult surgical resolution.
    UNASSIGNED: Clinical and imaging tests help in the diagnosis and tumor localization.
    UNASSIGNED: Adequate surgical knowledge for these cases ensures lower rates of recurrence and nail dystrophy.
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  • 文章类型: Case Reports
    背景:Glomus肿瘤是一种最常见于四肢的胞周间质肿瘤。内脏器官的发生很少见,可与其他胃粘膜下肿瘤鉴别诊断。
    方法:一名患有上腹痛的妇女接受了食管胃十二指肠镜(EGD)检查,发现胃粘膜下肿瘤。内镜超声与细针抽吸术可以在术前诊断胃血管球瘤。术中成功行EGD辅助腹腔镜胃段切除术。患者在术后第二天出院。随访8个月时无复发迹象。
    结论:胃是血管球瘤的罕见部位,血管球瘤的肿瘤,这是一个具有体温调节功能的血管周围结构。术前诊断具有挑战性,和内镜超声(EUS)对于评估恶性肿瘤相关特征和活检指导都很有用。治疗方法是手术切除,注意适当的肿瘤切缘,同时保留健康的胃壁。
    结论:通过EUS细针获得的标本的免疫组织化学分析可以进行准确的术前诊断,腹腔镜-内镜联合手术可以获得良好的肿瘤和功能结果。
    BACKGROUND: Glomus tumor is a pericytic mesenchymal neoplasm that most commonly occurs in the extremities. The occurrence in visceral organs is rare and is a differential diagnosis with other gastric submucosal tumors.
    METHODS: A woman with epigastric pain underwent esophagogastroduodenoscopy (EGD) which revealed a gastric submucosal tumor. Endoscopic ultrasound with fine-needle aspiration allowed preoperative diagnosis of gastric glomus tumor. Intraoperative EGD-assisted laparoscopic segmental gastrectomy was successfully performed. The patient was discharged in the second postoperative day. There was no evidence of recurrence at 8 months of follow-up.
    CONCLUSIONS: The stomach is a rare location for the glomus tumor, a neoplasm of the glomus body, which is a perivascular structure with thermoregulatory function. Preoperative diagnosis is challenging, and endoscopic ultrasound (EUS) is useful for both assessing malignancy-associated features and biopsy guiding. The treatment is surgical resection with attention to adequate oncological margins while preserving healthy gastric wall.
    CONCLUSIONS: Immunohistochemical analysis of specimen obtained by EUS fine-needle allows accurate preoperative diagnosis and laparoscopic-endoscopic combined surgery allows good oncological and functional results.
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  • 文章类型: Journal Article
    目的:回顾累及肌肉骨骼系统的血管球瘤的临床和影像学特征,包括典型的孤立形式以及罕见的多病灶形式(腺静脉畸形和肾小球血管瘤病)。
    方法:对我们1996年至2023年的机构病理学数据库的回顾性审查确定了176例患者,其中218例确诊为血管球瘤。主要影像学研究包括MRI(125),射线照片(100),临床/术中照片(77),和超声(36)。病变分为两组:那些通常是孤立的,涉及特定的解剖区域(手指,脚趾,软组织,尾骨,和骨头),和那些多灶性(腺静脉畸形和血管瘤病)。
    结果:51%的患者发生的典型(散发性)血管球瘤,手指是最常见的解剖位置,其中77%是女性,在75%的病例中,钉板涉及更多的病例。累及皮肤的散发性病变,皮下脂肪组织,深层软组织被称为“软组织”,“在39%的患者中被确认,其中90%在四肢,而81%的病例在男性中。血管球瘤疾病的多灶性综合征形式发生在年轻个体中,占研究组的不到6%。腺静脉畸形患者早期表现为主要皮肤受累,而那些患有血管瘤病的人后来出现,经常有肤浅和深度的参与,局部肿瘤复发率高。
    结论:虽然血管球瘤通常并不常见,它经常涉及肌肉骨骼四肢。了解特征位置和外观的频谱将有助于明确的诊断。
    OBJECTIVE: To review the spectrum of clinical and imaging features of glomus tumor involving the musculoskeletal system including the typically solitary forms as well as the rarer multifocal forms (glomuvenous malformation and glomangiomatosis).
    METHODS: A retrospective review of our institutional pathology database from 1996 to 2023 identified 176 patients with 218 confirmed glomus tumors. Primary imaging studies included MRI (125), radiographs (100), clinical/intraoperative photos (77), and ultrasound (36). Lesions were divided into two groups: those that are typically solitary involving specific anatomic areas (finger, toe, soft tissue, coccyx, and bone), and those that are multifocal (glomuvenous malformation and glomangiomatosis).
    RESULTS: The finger was the most frequently involved anatomic location for the classic (sporadic) glomus tumor occurring in 51% of patients, 77% of which were women, with the nail plate involved in more of the 75% of cases. Sporadic lesions involving the skin, subcutaneous adipose tissue, and deep soft tissue were termed \"soft tissue,\" and were identified in 39% of patients, 90% of which were in the extremities and in men in 81% of cases. The multifocal syndromic forms of glomus disease occurred in younger individuals and involved less than 6% of the study group. Patients with glomuvenous malformation presented early with predominantly cutaneous involvement, while those with glomangiomatosis present later, often with both superficial and deep involvement, and a high rate of local tumor recurrence.
    CONCLUSIONS: While glomus tumor is generally uncommon, it frequently involves the musculoskeletal extremities. Knowledge of the spectrum of characteristic locations and appearances will facilitate definitive diagnosis.
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  • 文章类型: Case Reports
    目的:鼓室球瘤和颈管肿瘤是高度血管化的,因此通常在手术切除前栓塞以防止术中出血。我们报告了一例使用乙烯乙烯醇(EVOH,也称为Onyx)栓塞剂对鼓室球瘤进行术前栓塞后出现面神经麻痹的病例。我们讨论了栓塞剂的选择与这种并发症的风险和潜在的管理策略。
    方法:A57F伴右侧鼓室球栓塞后立即出现右侧面神经麻痹。她在栓塞后的24小时内立即接受了24毫克地塞米松,手术面神经减压术同时切除肿瘤,和10天泼尼松锥度。我们的主要结局指标是随访体格检查时的面神经功能。
    结果:患者在Onyx栓塞颈外动脉系统分支后出现右面瘫(HB6/6),如栓塞后CT所见,可能是由于栓塞剂易位进入面神经血管。高剂量类固醇和减压没有观察到立即改善,然而,在接下来的6个月中,她的面神经功能开始改善(HB3/6)。
    结论:手术切除是治疗颈静脉球瘤和鼓室球瘤的标准方法。由于他们容易流血,他们的动脉喂食器(颈外动脉的分支)通常在手术前被栓塞,然而,面神经麻痹是一种罕见但严重的并发症。栓塞剂的选择与这种并发症之间可能存在关系。虽然面神经麻痹是足够罕见的,没有标准的治疗途径存在,由于对患者生活质量的影响,我们建议积极治疗以挽救神经功能。
    OBJECTIVE: Glomus tympanicum and jugulare tumors are highly vascular and are therefore commonly embolized before surgical resection to prevent intra-operative bleeding. We report a case of facial nerve paralysis after pre-operative embolization for a glomus tympanicum tumor with ethylene vinyl alcohol (EVOH also known as Onyx) embolic agent. We discuss the choice of embolic agent in relation to the risk of this complication and potential management strategies.
    METHODS: A 57F with right glomus tympanicum developed right facial nerve palsy immediately after embolization. She received 24 mg of dexamethasone over the course of 24 h immediately following her embolization, surgical facial nerve decompression concurrent with tumor resection, and a 10-day prednisone taper. Our main outcome measure was facial nerve function on follow-up physical examinations.
    RESULTS: The patient developed right facial paralysis (HB 6/6) after Onyx embolization of branches of the external carotid artery system, likely due to translocation of embolic agent into facial nerve vasa nervosa as seen on post-embolization CT. No immediate improvement was observed with high dose steroids and decompression, however over the next 6 months her facial nerve function began to improve (HB 3/6).
    CONCLUSIONS: Surgical excision is the standard of care for glomus jugulare and glomus tympanicum tumors. Due to their propensity to bleed, their arterial feeders (branches of the external carotid) are often embolized prior to surgery, however, facial nerve paralysis is a rare but serious complication. There is a possible relationship between the choice of embolic agent and this complication. Though facial palsy is of sufficient rarity that no standard treatment pathway exists, due to the impact on a patient\'s quality of life, we recommend aggressive therapy to salvage nerve function.
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  • 文章类型: Case Reports
    血管球瘤是皮下组织的罕见间充质肿瘤,最常见于四肢远端。它们通常是良性的,但是文献中已经描述了恶性血管球瘤。在这里,我们介绍了一名发现患有单侧肾脏肿块的患者,其病理显示具有恶性特征的原发性肾球瘤。文献复习仅显示3例恶性血管球瘤和5例具有恶性潜能的血管球瘤。因此,先前的初步介绍,目前血管球瘤恶性肿瘤的标准,并回顾了这些病例以前的治疗结果.
    Glomus tumors are rare mesenchymal neoplasms of the subcutaneous tissue, most frequently found in the distal extremities. They are typically benign, but malignant glomus tumors have been described in the literature. Here we present a patient found to have a unilateral renal mass with pathology displaying a primary renal glomus tumor with malignant features. Review of the literature reveals only three cases of malignant glomus tumors and five glomus tumors with malignant potential. As such, previous initial presentations, current criteria for glomus tumor malignancy, and previous treatment outcomes of these cases were reviewed.
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  • 文章类型: Case Reports
    血管球瘤是罕见的,起源于血管球体的良性肿瘤。虽然通常发生在手指的甲下区域,很少在脚部发现血管球瘤,尽管罕见的报道表明,在拇指和小脚趾的血管球瘤甚至更少。我们描述了一个报告的病例,该病例发生在左第二脚趾的远端指骨中,最初在影像学研究中被遗漏。导致延误诊断和手术治疗。据我们所知,这是在小脚趾报告的血管球瘤的前几个病例之一。
    一名34岁的中国女性出现了持续数年的左第二脚趾疼痛。初步评估和放射学检查异常结果为阴性,导致治疗延迟。根据核磁共振扫描的第二意见,发现了一个0.2×0.2×0.2cm轮廓清晰的圆形,增强了左第二趾甲下区域生发矩阵内的高T2加权信号焦点,暗示血管球瘤。提供了手术探索,发现了一个肤色的病变,是用一种透骨方法切除的。切除肿块的最终组织学显示均匀细胞的血管周围增生,其中包含圆形至卵圆形的核,核仁小,嗜酸性粒细胞苍白。确认血管球瘤。
    在足部很少发现血管球瘤,小脚趾的报告更少。它们在这些区域的罕见发生减少了对这些肿瘤的诊断怀疑,延迟患者的诊断和治疗。这个病例报告突出了诊断血管球瘤的困难,即使有足够的放射调查,并展示了仔细审查成像的必要性。由于这种演示非常罕见,我们希望该病例报告增加对血管球瘤的怀疑,作为脚趾疼痛的鉴别诊断,以确保患者的早期治疗和症状缓解。
    UNASSIGNED: Glomus tumors are rare, benign neoplasms that originate from glomus bodies. While usually occurring in the subungual regions of the fingers, glomus tumors are seldom found in the foot, although rare reports have been made of glomus tumors in the hallux and even fewer in the lesser toes. We describe a reported case of a glomus tumor occurring in the distal phalanx of the left second toe that was initially missed on imaging studies, resulting in delayed diagnosis and surgical treatment. To the best of our knowledge, this represents one of the first few cases of glomus tumor reported in the lesser toes.
    UNASSIGNED: A 34-year-old Chinese female presented with pain in the left second toe occurring for several years. Initial assessment and radiological investigations came back negative for abnormalities, resulting in delayed treatment. Upon second opinion of the MRI scans, a 0.2 × 0.2 × 0.2 cm well-defined round enhancing high T2-weighted signal focus within the germinal matrix of the left second toe subungual region was found, suggestive of a glomus tumor. Surgical exploration was offered, which found a skin-colored lesion, which was resected using a transungual approach. The final histology of the excised mass showed perivascular proliferation of uniform cells which contained round to ovoid nucleus with small nucleolus and pale eosinophilic cytoplasm, confirming glomus tumor.
    UNASSIGNED: Glomus tumors are rarely found in the foot, with even fewer reports in the lesser toes. Their rare occurrence in these regions reduces diagnostic suspicion for these tumors, delaying diagnosis and treatment for patients. This case report highlights the difficulty in diagnosing glomus tumors, even with adequate radiological investigations, and showcases the need for careful scrutinization of imaging. As this presentation is extremely uncommon, we hope that this case report increases suspicion of glomus tumors as a differential diagnosis for toe pain to ensure early treatment and alleviation of symptoms for patients.
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    文章类型: Case Reports
    血管球瘤是罕见的血管错构瘤,最常见于手指的甲下区域。他们呈现出典型的阵发性疼痛三合会,点压痛,冷敏感性。由于认识到这种情况,诊断通常会错过几年。一名42岁的女性在中指被击中或暴露于寒冷时出现了数年的疼痛史。她指甲上有点压痛,并增加了指甲的曲率。磁共振成像(MRI)显示7mm甲下血管球瘤。肿瘤是通过经骨入路手术切除的,完全减轻了她的痛苦.根据经典症状和积极的挑衅性试验的存在,在临床上诊断血管球瘤。这些测试包括触诊时的点压痛和在手指上放置冰时的疼痛。当诊断不清楚或在手术前定位肿瘤时,可以使用MRI成像。提高医生对这种情况的认识可以减少诊断和治疗的时间。
    Glomus tumors are rare vascular hamartomas most commonly found in the subungual region of the fingers. They present with a classic triad of paroxysmal pain, point tenderness, and cold sensitivity. The diagnosis is often missed for several years due to under recognition of this condition. A 42-year-old female presented with a several year history of pain in the middle finger when it was struck or exposed to cold. She had point tenderness on the fingernail, and increased curvature of the nail. Magnetic Resonance Imaging (MRI) revealed a 7mm subungual glomus tumor. The tumor was surgically excised via a transungual approach, resulting in complete relief of her pain. Glomus tumors are diagnosed clinically based on the presence of classic symptoms and positive provocative tests. These tests include point tenderness on palpation and pain when ice is placed on the digit. MRI imaging can be used when the diagnosis is unclear or to localize the tumor prior to surgery. Increased awareness of this condition among physicians could reduce the time to diagnosis and treatment.
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  • 文章类型: Case Reports
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