Glomangioma of the popliteal fossa. Apropos of a case

Glomus tumours are relatively uncommon lesions most frequently found in the extremitis, usually in the digits. They are most often solitary lesions but multiple tumours have been reported. If the triad of pain, tenderness and cold intolerance should raise the clinical suspicion of a digital glomus. The histological exam is necessary in the extra digital glomus. We reported a case of fossa poplitea glomangioma with tibialis nerve compression. The treatment of choice was a surgical exision. But the tumour have been redivided a year later without malign transformation.     

Anomalous drainage of right superior vena cava into the left atrium

Tracheal glomus tumors are extremely rare. We present herein the case of a 43-year-old man with hoarseness who was found to have a glomus tumor arising from the lower trachea. Bronchoscopy and chest computed tomography revealed a polypoid mass in the membranous portion of the trachea just above the carina. The patient underwent successful tracheal sleeve resection and reconstruction. A pathologic diagnosis of a glomus tumor with clear surgical margins was subsequently confirmed, and the patient is well 20 months postoperatively with an intact anastomosis.     

Lower respiratory tract infections in the intensive care unit: consequences of antibiotic resistance for choice of antibiotic

BACKGROUND: The glomus tumor is an uncommon tumor of the hand, which presents with much pain. It is a benign neoplasm composed of a glomus body, which is located in the dermis. Glomus tumors present a classic clinical picture of pain, sensitivity to cold and local tenderness over the lesion. METHODS: Twelve patients underwent surgical removal for glomus tumors of the upper extremity from 1983 to 1992. There were three males and nine females; their average age was 37 years (25 to 60 years). The clinical manifestations were pain and local tenderness in 12 patients, and cold intolerance in 6 patients. RESULTS: There was a difference in gender in the anatomical site of the tumor. In three male patients, only one tumor was found in the digit. In female patients, all nine tumors were located in the digits. The average tumor size was 0.6 cm in diameter. After follow-up of 4.5 years (average), no recurrence, no residual pain or cold intolerance was noted. CONCLUSIONS: The treatment of glomus tumor consisted of local excision or curettage, with or without reconstruction of the nail bed. Recurrence is not a problem after complete removal of the tumor tissue. Permanent nail deformity is still a problem. Efforts to prevent this sequelae are worth trying.     

Oligosymptomatic glomus tympanicum and caroticium with two different histological pictures

Though glomus tumors have been relatively frequently reported, there is very little material about their differential diagnostic problems. The authors present a case of glomus tympanicum and glomus caroticum with only otological symptoms, facial paralysis and traumatic arterio-venous shunts in the neck. These two tumors had few different patterns of glomus tissue.     

Plasma lipid changes in the female mule duck (Cairina moschata x Anas platyrhynchos) experimentally infected with Eimeria mulardi

We have tested the suitability of chromaffin-like carotid body glomus cells for dopamine cell replacement in Parkinsonian rats. Intrastriatal grafting of cell aggregates resulted in almost optimal abolishment of motor asymmetries and deficits of sensorimotor orientation. Recovery of transplanted animals was apparent 10 days after surgery and progressed throughout the 3 months of the study. The behavioral effects were correlated with the long survival of glomus cells in the host brain. In host tissue, glomus cells were organized into glomerulus-like structures and retained the ability to secrete dopamine. Several weeks after transplantation, dopaminergic fibers emerged from the graft, reinnervating the striatal gray matter. The special durability of grafted glomus cells in the conditions of brain parenchyma could be related to their sensitivity to hypoxia, which is known to induce cell growth, excitability, and dopamine synthesis. This work should stimulate research on the clinical applicability of carotid body autotransplants in Parkinson's disease.     

Carotid body chemoreception: the importance of CO2-HCO3- and carbonic anhydrase. (review)

The current hypotheses of carotid body (CB) chemoreception regard the glomus cells as the initial site of stimulus transduction. The consensus is that the transduction of chemical stimulus is coupled with the release of transmitter(s) from the glomus cells, which in turn generates action potentials in the afferent nerve terminals. Carbonic anhydrase (CA) is present in the glomus cells of the CB. Inhibition of CA activity in the CB in situ reduces the carotid chemosensory responses to CO2 and to O2, suggesting a common mechanism of chemosensing for both stimuli. However, CA inhibitors also block the red blood cell enzyme. Thus, the CO2 hydration reaction does not come to completion within the transit time of the blood from the lung to the CB. A steady-state reaction is not reached until later and so the PCO2 and pH levels in arterial blood samples are not the same as those sensed by the CB. Experiments in vitro using cat CB perfused and superfused with cell-free solutions, which had been pre-equilibrated with respiratory gases, strongly support the proposition that the CA activity in CB cells is essential for the speed and amplitude of the initial response to CO2 and for its subsequent adaptation. The immediate response to hypoxia also is delayed, but the late steady-state was less dependent on CA activity. In the nominal absence of CO2-HCO3- from the perfusate, hypoxic chemoreception persisted and its magnitude is not affected by CA inhibition, except for a delay which may be due to the initial alkaline pH of the glomus cells. Recent experiments performed in isolated glomus cells and in the whole CB show that hypoxia does not modify significantly the intracellular pH. By its simple catalytic function, CA can speed up the approach of the CO2 hydration reaction to equilibrium. However, CA may also contribute in the steady-state to the regulation of pHi by providing a continuous supply of H+ and HCO3-. Furthermore, CA performs a facilitatory role in the physiological chemosensory responses to CO2 and O2 in the presence of extracellular CO2-HCO3-. This role is likely to be related to the ion exchanger function and then to pHi regulation in the chemoreceptor cells.     

Carotid body adaptation to hypoxia: cellular and molecular mechanisms in vitro

Chronic hypoxia in vivo promotes long-term changes in the carotid body (CB) response to low PO2. By exposing cultured rat CB chemoreceptors (glomus cells) to 6% O2 for 1-3 weeks, we are investigating the cellular and molecular mechanisms of hypoxic adaptation. Recent studies have uncovered a series of plastic changes in glomus cells including hypertrophy, differential regulation of Na+, Ca2+, and K+ currents, and upregulation of the 'plasticity protein', GAP-43. We have also identified cyclic AMP as a possible intracellular mediator of at least some of these effects of chronic hypoxia. Associated with the changes in ionic currents, glomus cells become electrically more excitable. However, a complete understanding of the physiological response of chronically hypoxic glomus cells to chemostimuli will require more detailed knowledge of the specific alterations in the sensing and signaling pathways, including modifications in neurotransmitter (e.g. catecholamine) functions.     

Control of advanced chemodectomas of the head and neck with irradiation

Long-term follow-up of 15 patients treated with definitive radiotherapy for advanced glomus tumors of the head and neck is presented. Disease was locally controlled in all patients. A prescribed dose above 4,500 cGY did not improve treatment results. Radiation therapy remains the treatment of choice for advanced glomus tumors.     

A morphological study of the carotid body and the fibre content of carotid nerve in the buffalo

In the buffalo the carotid body is located in the periarterial connective tissue of the occipital artery immediately cranial to the bifurcation of the common carotid artery. The carotid body is lobulated and does not appear to contain chromaffin tissue. Nerve terminals have been seen in close relation to the glomus cells. A quantitative study of the fibre content of the carotid nerve and the carotid body has also been made. The myelinated fibres in the carotid nerve range from 278 to 473, with a mean of 368 +/- 39 fibres. The histogram of myelinated fibres is distinctly unimodal. Of the myelinated fibre population, 55.4% of fibres have diameters of 2 mum, 34.1% of 4 mum, 9.5% of 6 mum and 1% have diameters of 8 mum. The mean greatest sagittal sectional area of the carotid body is 0.58 +/- 0.09 mm2. The mean density (per mm2) of glomus cells is 9,216 +/- 378. It appears that the organ is highly vascular (473 +/- 56 blood vessels/mm2 area). The mean size of the glomus cells is 7.85 +/- 0.46 mum X 10.02 +/- 0.64 mum (short diameter X long diameter), whereas the mean size of their nuclei is 4.96 +/- 0.19 mum X 5.52 +/- 0.27 mum.     

Glomus tumor in the upper lip. A case report

A glomus tumor arising in the upper lip of a 54-year-old Japanese man is presented.     

Pain in the family

A case is reported of atypical glomus tumor occurring in the posterior inferior mediastinum of a 26-year-old woman complaining of severe back pain. The tumor was composed of atypical small, round tumor cells with scattered mitotic figures. In addition to sheet-like, diffuse proliferation of the tumor cells, some areas of the tumor contained small "glomoid" cells arranged in organoid and hemangiopericytomalike patterns. Immunohistochemically, many tumor cells were positive for muscle-type actins and a few cells were focally positive for desmin. Ultrastructural studies revealed smooth muscle features of tumor cells, that is, pinocytotic vesicles, external laminas, dense plaques, and occasional thin filaments with dense bodies. The patient remained well for 5 years and 4 months after the operation without additional radiation and chemotherapy. The tumor was diagnosed as an atypical, or low-grade malignant, glomus tumor morphologically. It seems important to recognize the presence of this type of tumor in sites other than extremities and to differentiate it from other malignant small, round cell tumors.     

High PCO does not alter pHi, but raises [Ca2+]i in cultured rat carotid body glomus cells in the absence and presence of CdC12

We measured the effect of high PCO (500-550 Torr) on the pHi and [Ca2+]i in cultured glomus cells of adult rat carotid body (CB) as a test of the two models currently proposed for the mechanism of CB chemoreception. The metabolic model postulates that the rise in glomus cell [Ca2+]i, the initiating reaction in the signalling pathway leading to chemosensory neural discharge, is due to [Ca2+] release from intracellular Ca2+ stores. The membrane potential model postulates that the rise in [Ca2+]i comes from influx of extracellular Ca2+ through voltage-dependent Ca2+ channels (VDCC) of the L-type. High PCO did not change pHi at PO2 of 120-135 Torr, showing that CO-induced changes in [Ca2+]i are not due to changes in pHi. High PCO caused a highly significant rise in [Ca2+]i from 90+/-12 nM to 675+/-65 nM, both in the absence and in the presence of 200 microM CdCl2, a potent blocker of L-type VDCCs. This result is fully consistent with release of Ca2+ from glomus cell intracellular stores according to metabolic model, but inconsistent with influx of extracellular Ca2+ through VDCCs according to the membrane potential model.     

Subungual glomus tumor: combined use of MRI and three-dimensional contrast MR angiography

We describe a case of digital glomus tumor diagnosed by MRI and three-dimensional contrast MR angiography (MRA). Images provided the formal definitive diagnosis and the precise localization of the tumor, guiding the necessary surgical resection. It is possible that noninvasive MRA could replace conventional arteriography for the evaluation of patients with clinical suspicion of glomus tumor.     

MR tomography and MR angiography of an extensive glomus jugulare tumor

The diagnosis of a glomus jugulare tumour was established by MR tomography and MR angiography. MR tomography demarcated the tumour from the surrounding tissue and MR angiography showed the vascularity of the glomus tumour.     

Sclerosing in multiple familial glomangiomas

Glomus tumors (glomangiomata) are benign tumors arising from glomus cells. Multiple glomangiomata are less frequent and less painful than the solitary variant, which is usually located subungually. Nonetheless multiple glomangiomata--sometimes being sensitive to pressure and changes in temperature--may cause considerable discomfort. Treatment of multiple glomangiomata is problematic because of the often large number of tumors. Sclerotherapy represents an alternative to surgical and cryosurgical therapy. We report on sclerotherapy in a 35 year old female patient with multiple hereditary glomus tumors.     

Glomus tympanicum in infancy

A glomus tympanicum tumor, limited to the cochlear promontory, was excised from the middle ear of a 6-month-old girl. To our knowledge, there have been no reports of temporal bone paragangliomas occurring at a younger age. Diagnosis, therapy, and the special characteristics of pediatric glomus tumors are discussed.     

The nephron microanatomy of the kidney in the lamprey Lampetra fluviatilis L. before and after metamorphosis

Isolated nephrons from premetamorphic lamprey larvae and adult animals were obtained using microdissection and kidney collagenase treatment methods. Significant differences in the architectonics of kidney tubules were found in larvae as compared with adults. The position of larval kidney was cranial while that in adult lampreys was caudal. The absence of nephron loop was noted in larval kidney. Distal and proximal tubules were shifted one from another in mediolateral direction. Distal tubule was significantly larger than proximal one. Mesonephric duct was located laterally near the glomus. Kidney tubules morphogenesis and nephron population number increase was observed at premetamorphic stage of larval kidney development.     

Pseudo pectus excavatum (author''s transl)

Seventy seven angioleiomyomata from 75 patients, 19 males and 55 females, are reviewed. One patient had 2 lesions and another a local recurrence after surgical excision. Only 3 were less than 20 years old and most were beyond 30 (average age 47). Fifty four lesions were on the lower limbs, 4 on the head and legs), 9 on the upper limbs, 4 on the head and 1 on the trunk. The size of the lesions varied from a pepper grain to a pigeon egg but most were pea sized. The more significant symptom was pain, present in at least 58% of the lesions, and responsible for the diagnosis, often made, of neurofibroma, neuroma, glomus tumour and leiomyoma. Its intensity was variable and could be induced by mechanical or thermal stimuli or even arise spontaneously. Histologically the tumour was usually a deep dermal or hypodermal, well defined, ovoid or round shaped, compact nodule, composed of smooth muscle fibers often disposed around variously shaped vascular lumina. Clinical and histological similarities to glomus tumours as well as the occasional coexistence of both lesions point to a common origin from the myoarterial glomus or from a closely related arteriovenous anastomosis. The relevant features in our series are compared with those reported in the literature and their similarities and differences are discussed.     

Methylenetetrahydrofolate reductase polymorphism, dietary interactions, and risk of colorectal cancer

Glomangiosarcoma is a rare malignant variant of the glomus tumor (GT). It has been reported in different anatomical locations, with only 1 report of its localization to the hand, despite the fact that its benign counterpart is most frequently found there. There is only 1 report of glomangiosarcoma that has metastasized. Special attention should be paid to GTs that are not well circumscribed, since the possibility of persistence and malignant transformation is increased in these lesions. The treatment of choice for glomangiosarcomas is wide local excision.