Glomangiomyoma (Glomus Tumour) of the Kidney: Case Report and Review of the Literature

Background: Glomus tumour is a rare mesenchymal neoplasm affecting the subcutaneous tissue of the distal extremities in the majority of cases. Glomus tumour rarely involves visceral organs. Glomus tumour involving the kidney is extremely rare and would not be encountered by most medical practitioners. In view of the rarity of glomus tumour of the kidney, its biological behaviour may not be known or understood by most medical practitioners. Aims: To report a case of glomangiomyoma (glomus tumour) of the kidney To review the literature related to glomus tumour of the kidney and other organs Case Report: A 32-year old man presented with a history of vague upper abdominal discomfort and he requested to be investigated to exclude the possibility of a malignancy. He had ultrasound scan of the abdomen including renal tract and pelvis which revealed a lesion in the lower pole of his left kidney. This was thought to be either a complex renal cyst or a renal tumour. He had CT scan and MRI scan of thorax, abdomen and pelvis which revealed an enhancing mass in the lower pole of his left kidney. He underwent left lower pole partial nephrectomy, pursuant to which he has remained well for 20 months without any CT scan and MRI scan evidence of recurrence. Histology of the partial nephrectomy specimen was seen by th ree pa tho log is ts and had fea tu res o f glomangiomyoma of kidney (a variant of glomus tumour. Literature review revealed that only thirteen cases of renal glomus tumour have been reported so far. All but one of the glomus tumours, have been benign and they have not recurred. Only one reported case of glomus tumour of the kidney had histological characteristics of a malignant tumour. Conclusions: Glomus tumour of the kidney is extremely rare. Including our reported case a total of fourteen glomus tumours of the kidney have been reported in the world literature. Twelve of the tumours, have been benign, one of the tumours was classified as infiltrating glomus tumour of uncertain malignant potential and one malignant glomus tumour of kidney. Our reported case of glomangiomyoma (a type of glomus tumour) of the kidney is the 12th benign glomus tumour of the kidney to be reported in the world literature and the 1th benign glomus tumour of the kidney to be reported in the English literature. Benign glomus tumours are usually encapsulated. Diagnosis of glomus tumour in the body including the kidney is based upon (a) characteristic microscopic findings; (b) immmunohistochemistry to support the diagnosis in the morphological context (glomus tumours are positive for alpha (and so do many other tumours) smooth muscle actin and vimentin and some of the tumours stain positively for CD 34); (c) characteristic electron microscopic findings.