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Presented by Jonathan Epstein, M.D. and prepared by Mark Samols, M.D. Ph.D.
Case 3: 14 year old male was noted to have a lesion on the leg.
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1. Question
Week 521: Case 3
14 year old male was noted to have a lesion on the leg.images/samols/0723123a.jpg
images/samols/0723123b.jpg
images/samols/0723123c.jpgCorrect
Answer: Glomangioma
Histology: The lesion is characterized at low magnification by large cavernous vessels. At higher magnification the vessels are lined by a relatively thin cuffing of monotonous cells. The cells have uniform round nuclei without cytologic atypia and lightly eosinophilic cytoplasm.
Discussion: This lesion is classic for a glomangioma. Glomangiomas occupy approximately 20% of glomus tumors. Amongst patients with multiple or familial glomus lesions, glomangiomas are the most common. Clinically glomangiomas tend to be less painful than glomus tumors. Glomus tumors typically occur in the distal extremities, particularly the subungual region on the hand and the foot, yet they may be seen everywhere. These lesions are entirely benign. Histologically, malignant glomus tumors are exceedingly rare and should be reserved for tumors with one of the following features:
1) greater than 2 cm with subfascial or visceral locations;
2) atypical mitotic figures; or
3) marked nuclear atypia with mitotic activity.Incorrect
Answer: Glomangioma
Histology: The lesion is characterized at low magnification by large cavernous vessels. At higher magnification the vessels are lined by a relatively thin cuffing of monotonous cells. The cells have uniform round nuclei without cytologic atypia and lightly eosinophilic cytoplasm.
Discussion: This lesion is classic for a glomangioma. Glomangiomas occupy approximately 20% of glomus tumors. Amongst patients with multiple or familial glomus lesions, glomangiomas are the most common. Clinically glomangiomas tend to be less painful than glomus tumors. Glomus tumors typically occur in the distal extremities, particularly the subungual region on the hand and the foot, yet they may be seen everywhere. These lesions are entirely benign. Histologically, malignant glomus tumors are exceedingly rare and should be reserved for tumors with one of the following features:
1) greater than 2 cm with subfascial or visceral locations;
2) atypical mitotic figures; or
3) marked nuclear atypia with mitotic activity.
