Multiple glomus tumours: A rare dermatological presentation
Glomus tumours are rare, benign proliferations of glomus cells and modified smooth muscle cells, which line the endothelium of thermoregulatory arteriovenous anastamoses in the dermis, known as glomus bodies. 1 Lesions are usually solitary, occurring in distal extremities, usually the subungal regions of fingers, where glomus bodies are abundant. 1
Multiple glomus tumours, also known as glomangiomas or glomuvenous malformations, are an uncommon phenotype (~10%) of glomus tumours, thus clinical diagnosis is frequently challenging. They often show familial aggregation with autosomal dominant inheritance, arising in childhood and adolescence, and are linked to truncating mutations of the glomulin gene located on chromosome 1p21-22. 1,2 Unlike solitary glomus tumours, lesions are rarely subungal, show no predilection for any particular bodily region and are often asymptomatic. Furthermore, morphology is often similar to cutaneous vascular malformations, and differentiation from conditions such as Blue Rubber Bleb Nevus Syndrome is important as treatment differs. Whilst lesions do not generally invade into deeper structures, rare reports of painful glomus tumours arising in internal organs where glomus bodies do not physiologically exist have been described.
We report a healthy 26yo female with multiple, painless, compressible, blue and violaceous nodular plaques on her back and limbs since childhood. These lesions were asymptomatic but cosmetically concerning, and several family members were also affected. Histopathology confirmed glomangiomas. Given her extensive cutaneous lesions and plans for pregnancy, thorough radiological examination was undertaken to exclude internal organ involvement, which was unremarkable. She elected a conservative treatment approach, and remains under observation.
1. Bachmeyer C, Aractingi S. Neutrophilic eccrine hidradenitis. Clin Dermatol 2000; 18:319-330.
2. Bidinger J, Sky K, Battafarano, et al. The cutaneous and systemic manifestations of Azathioprine hypersensitivity syndrome. J Am Acad Dermatol 2011; 65: 184-91.
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Dr. Janet Kim
2nd year dermatology registrar
Adelaide, South Australia
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