Journal of Postgraduate Medicine Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India ISSN: 0022-3859 EISSN: 0972-2823 Vol. 56, Num. 3, 2010, pp. 218-219

Journal of Postgraduate Medicine, Vol. 56, No. 3, July-September, 2010, pp. 218-219

Case Snippet

Glomus tumor occuring in male breast - An unusual site of presentation

Mehdi G, Siddiqui FA, Ansari HA, Mansoor T¹

Departments of Pathology, ¹ General Surgery, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India

Correspondence Address: Dr. Ghazala Mehdi, Department of Pathology, Jawaharlal Nehru Medical College, AMU, Aligarh, Uttar Pradesh, India, gmehdi@hotmail.com

Code Number: jp10062

PMID: 20739772

DOI: 10.4103/0022-3859.68638

Glomus tumors are benign neoplasms arising from modified smooth muscle cells located in the walls of specialized arteriovenous anastomoses, fulfilling a temperature regulatory function. ^[1]

The breast is an extremely rare location for glomus tumor. A similar case has been reported recently in a female patient. ^[2] However, to the best of our knowledge, no such case has been reported in the male breast.

A 25-year-old male presented with a painful nodule in the right breast for the past one month. On examination, the mass was tender, firm, about 1 cm in diameter, located in the upper inner quadrant. Overlying skin was normal. The mass was excised and submitted for histopathological examination. Grossly, it was smooth, grayish white in color. Microscopic examination revealed anastomosing nests and sheets of tumor cells surrounding dilated vascular spaces [Figure - 1]. The tumor cells were uniformly monotonous with oval to round hyperchromatic nuclei, homogeneous chromatin and scant eosinophilic cytoplasm [Figure - 2]a. No cellular atypia or mitoses were observed. Periodic Acid Schiff (PAS) stain demonstrated the presence of basal lamina material around the cells [Figure - 2]b. On the basis of these findings, a diagnosis of glomus tumor was rendered.

Glomus tumors were first described by Masson in the year 1924. ^[3] These are commonly seen in young adults, located in the subungual regions of the finger, palm, wrist, forearm and foot, as well as in unusual sites. ^[4]

Though usually benign, some aggressive variants have also been reported. ^[5] The new WHO classification categorizes these tumors into glomus tumor, glomus tumor of uncertain malignant potential and malignant glomus tumor. ^[6] The diagnostic criteria of malignancy includes (i) size greater than 2 cm and a subfascial location, (ii) atypical mitotic figures and (iii) moderate-to-high nuclear grade and five or more mitotic figures per 50 high-power fields. ^[5]

Special stains like PAS and immunohistochemistry are useful in confirming the diagnosis. ^[6]

The differential diagnosis of glomus tumor includes cutaneous adnexal neoplasms like eccrine spiradenoma, intradermal nevus with pseudovascular spaces, simple cavernous hemangioma, and carcinoid tumor.

In the light of its varied differential diagnoses, the possibility of a glomus tumor should be kept in mind, even in tumors which occur at sites where glomus cells are sparse or unrecognized.

References

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