腎臟惡性血管球瘤-病例報告
賴谷順、裘坤元、熊小澐、王約翰
臺中榮民總醫院 外科部泌尿外科1放射線部2病理部3
Malignant glomus tumor of kidney-a case report
Gu-Shun Lai, , Kun-Yuan Chiu1 Siu-Wan Hung2 John Wang3
1Division of Urology, Department of Surgery,
2Department of Radiation and
3Department of Pathology, Taichung Veterans General Hospital, Taichung, Taiwan
Introduction: Glomus tumors are mesenchymal neoplasms that resemble normal glomus body. Glomus tumors most often occurred in the extremities, and rarely arise from visceral organ. Herein, we report a rare case of malignant glomus tumor arising from kidney.
Case report: A 46 years old man with history of nasopharynx cancer, status post chemoraiation therapy, has right renal tumor found incidentally on a pulmonary computed tomography scan for following of nasopharynx cancer. A contrast enhanced computed tomography of abdomen showed a tumor about 4.4cm with heterogenous enhancement over medial upper pole of right kidney. The patient undertook laparoscopic right radical nephrectomy with right adrenalectomy and recovered well after the operation. According to the histologic and immunohistochemical examination, the tumor is diagnosed as malignant glomus tumor.
Discussion: Glomus tumors resemble glomus body, which is associated with body temperature regulation. Glomus tumors usually occur in the extremities, most common the subungual region of the fingers. Visceral organs are uncommon site involving development of glomus tumors. Glomus tumors arising from kidney are extremely rare, with a few cases described before.
It is difficult to differentiate glomus tumor from other renal malignany preoperatively through imaging study. Histolgoy and immunohistochemical study are necessary to make a diagnosis of glomus tumor of the kidney. Renal glomus tumors are usually benign with good outcome and prognosis, with one exception of malignant glomus tumor been reported. We report a case of malignant glomus tumor of kidney. To our knowledge, this is the second case of malignant renal glomus tumor reported. Given the small number of cases reported to date and relative short-term follow up, close clinical follow-up is necessary.