An Extraordinary Association of Glomus Tumor and Pacinian Hyperplasia in the Hand of a Female Patient.
BACKGROUND
Glomus tumor is a benign neoplasm of the glomus body, a neuromyoarterial structure that regulates temperature and pressure in the cutaneous vasculature. Approximately 1%-4.5% of glomus tumors present in the hands of females; of these, 65% are seen in the subungual region of the index and long fingers. Pacinian hyperplasia is a benign lesion of the Pacinian corpuscle, a mechanoreceptor located in the subcutis of the hands and feet.


METHODS
A 65-year-old woman with a history of hand trauma and a 1-year chief complaint of tingling, pain, and burning sensations in her proximal thumb underwent exploration of the digital nerve after an x-ray and 2 magnetic resonance imaging examinations failed to detect a mass. Two lesions immediately adjacent to each other were excised.


RESULTS
Microscopic examination showed Pacinian hyperplasia, and a second proliferation of solid epithelioid cells related to benign blood vessels. Immunohistochemistry confirmed the epithelioid cells to be strongly positive for smooth muscle actin, CD34, and type 4 collagen, which is consistent with the phenotype of a glomus tumor. The cells were negative for S100 protein.


CONCLUSIONS
The association of glomus tumor with Pacinian hyperplasia has rarely been reported in the literature. We present another rare case to bring awareness to this differential diagnostic consideration.
Department of Pathology, Duke University Medical Center, Durham, NC.
Miglena
M
Komforti
Thomas J
TJ
Cummings
D000368:Aged; D005260:Female; D005918:Glomus Tumor / Q000473:pathology*; D006225:Hand / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D007150:Immunohistochemistry; D010141:Pacinian Corpuscles / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000473:pathology*