Malignant Glomus Tumor of the Thyroid Gland Where Is Heretofore an Unreported Organ: a Case Report and Literature Review
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Malignant Glomus Tumor of the Thyroid Gland Where Is Heretofore an Unreported Organ: a Case Report and Literature Review Dong Hae Chung & Na Rae Kim & Taeeun Kim & Jungsuk Ahn & Sangho Lee & Young Don Lee & Hyun Yee Cho
Published online: 28 December 2014 # Springer Science+Business Media New York 2014
Abstract Glomus tumors are relatively uncommon clinically benign tumors. Malignant glomus tumors are rare, and only a small number develop metastatic foci. The usual location is deep dermis or subcutis, but it has been reported in various locations. A 55-year-old man presented with an incidentally found thyroid mass. Neck ultrasound showed a mass with a heterogeneous hypoechoic calcific mass in the right lobe. Right lobectomy specimen showed the 3.6-cm-sized calcified mass composed of sheets of uniform round to polygonal cells and intervening staghorn-shaped vessels. Occasional cellular atypism and necrosis with increased mitotic activity (up to 7 per 10 high-power fields) were found. Infiltration to the residual thyroid parenchyma, vessel, thyroidal capsule, and strap muscle was found. These tumor cells were strongly positive for smooth muscle actin, collagen type IV, and vimentin with pericellular reticulin-cuffing. Ultrastructurally, closely packed ovalshaped tumor cells having cytoplasmic mitochondria, rough endoplasmic reticulums with pinocytotic vesicles along the plasmalemmal surface and thin filaments of 6 nm in diameter were surrounded by thick basal lamina. That mass was diagnosed as a malignant glomus tumor. Incidentally, a 0.5-cm-sized papillary carcinoma D. H. Chung : N. R. Kim (*) : J. Ahn : S. Lee : H. Y. Cho Department of Pathology, Gachon University Gil Medical Center, 21 Namdong-daero 774 beon-gil Namdong-gu, Incheon 405-760, Korea e-mail: [email protected] Y. D. Lee Department of General Surgery, Gachon University Gil Medical Center, Incheon, Korea T. Kim Department of Pathology, Kangneung Asan Medical Center, Ulsan University School of Medicine, Kangneung, Kangwondo, Korea
was found through entire embedding. Complete thyroidectomy with chemotherapy was done. Thirty months later, multiple metastases developed in the brain and lung, and he expired. To our knowledge, neither benign nor malignant thyroid glomus tumor has been previously described. Here, we describe the first case of a malignant glomus tumor in the thyroid gland. Keywords Malignant glomus tumor . Thyroid . Microscopy, electron
Introduction Glomus tumor is a distinctive neoplasm originating from modified smooth muscle cells, i.e., glomocytes of the neuromyoarterial glomus, or the normal glomus body, a specialized structure involving temperature regulation [1]. Various names have been assigned to this tumor, including nonchromaffin paraganglioma, chemodectoma, and receptoma. The entity of glomus tumor should not be confused with similar name of paraganglioma of the head and neck arising from cells of glomus jugulare or glomus tympanicum, i.e., neuroendocrine cells [2]. Glomus tumors are most commonly located in the subungual reg
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