Intraosseous spinal glomus tumors

AbstractOBJECTIVEGlomus tumors are rare lesions that can arise intraosseously along the entire spinal axis. Only four cases have been reported, usually manifesting with severe back pain and involving the midthoracic spine or sacrum. The current report describes the largest such lesion reported in the literature to date and summarizes the clinical and pathological characteristics of these rare tumors.METHODSA single, recent case arising from the lumbar vertebra of L3 is described, and the literature of intraosseous spinal glomus tumors is reviewed.RESULTSThe lesion described arose in a 44-year-old man with a 1-year history of neurological symptoms and a large dumbbell-shaped lesion involving the lumbar vertebra, which extended through the neural foramen at L3. The lesion was resected using a two-stage approach. Severe intraoperative hemorrhage necessitated emergent angiographic embolization. Histopathological examination confirmed the presence of a glomus tumor arising from the smooth muscle cells of the glomus body.CONCLUSIONThese rare lesions may extend into the epidural space and through the neural foramina and abdominal compartments; over time, they grow very large. Preoperative embolization may be indicated for large tumors suspected to be glomus tumors.