Track: Case Reports

Topic: Neoplasia,Carcinogensis,Tumor Biology

Abstract:

Glomus tumors are rare soft tissue tumors of the glomus body, most commonly arising in the hands and feet. The glomus body is composed of glomus cells resembling modified epithelium functioning in thermoregulation of arteriovenous shunts. Here we present a case of a solid glomus tumor in the clitoris, only the sixth case of a clitoral glomus tumor in the literature. Glomus tumors present with a triad of paroxysmal pain, temperature sensitivity, and tenderness to touch. The patient experienced years-long debilitating pain. With imaging showing no definitive finding consistent with the patient’s severe degree of pain, the patient underwent multiple exploratory procedures. Ultimately, the patient underwent an intraoperative biopsy of a 5 mm smooth, mobile clitoral mass assuming to be a cyst. The mass showed sheets of uniformed cells displaying positive staining for SMA and negative for keratin and melanocytic markers supporting diagnosis of glomus tumor. There are several tumors capable of arising in the highly vascularized and nerve-rich clitoris. This case expands the differential diagnosis of smooth muscle expressing tumors within the clitoris. Differential diagnoses for smooth muscle masses of genitalia are myopericytoma, hamartomas, leiomyoma/leimyosarcoma, adnexal tumor, angioleiomyoma, and hemangiomas. SMA is not an entirely specific marker and can be positive in several non-smooth-muscle neoplasms. Although such tumors can cause pain, the presence of disproportionate pain should raise the possibility of glomus tumor. Delay in diagnosis may lead to development of post-traumatic stress disorder symptoms related to excruciating pain, seen here and in one historical case.

Doaa Atwi

Affiliation

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(369) Years of Excruciating Pelvic Pain Leading to Post-Traumatic Stress Disorder (PTSD): The Story of a Missed Clitoral Hood Glomus Tumor