Glomus tumour of the kidney

Glomus tumours most commonly occurs in the subcutis of the distal extremities but rare renal glomus cell tumours have been reported.

Clinical features

Presentation is usually with a renal mass.

Macroscopic appearances

The tumour may be located in the parenchyma1 or in the renal capsule2. One cases was located in the distal renal pelvis4.

Histopathology

The histological appearances cover the spectrum from solid glomus tumour1 to glomangioma1,2 to glomangiomyoma1,3.

Immunohistochemistry

	SMA	3/31
	Laminin	pericellular staining in 3/31
	Desmin	0/31
	S-100	0/11
	HMB-45	0/11
	Melan-A (A103)	0/11
	Cam5.2	0/11
	AE1/AE3	0/11
	CD10	0/11
	bcl-2	0/11
	EMA	0/11
	CEA	0/11
	CD31	endothelial cells only in 3/31
	CD34	endothelial cells in 3/3 and myoid cells in 1/31

Ultrastructure

Cells are surrounded by a continuous external lamina and contain numerous mitochondria, clusters of actin microfilaments and numerous pinocytotic vesicles.

Differential diagnosis

Epithelioid glomus tumour: renal cell carcinoma: Immunohistochemistry distinguishes, with renal cell carcinoma positive for cytokeratins and EMA but negative for SMA.
Angiomyolipoma: should show all three components, smooth muscle, adipose tissue and thick walled vessels; it is positive for HMB-45 and Melan-A.
Lymphangioleiomyomatosis
Leiomyoma
Renal haemangioma
Juxtaglomerular cell tumour: affects young adults and is associated with severe hypertension, hyperkalaemia and high plasma renin levels.

References

1 Al-Ahmadie HA, Yilmaz A, Olgac S, et al. Glomus tumor of the kidney: a report of 3 cases involving renal parenchyma and review of the literature. Am J Surg Pathol 2007; 31:585-91

2 Billard F, Dumollard JM, Cucherousset J, et al. [Two benign vascular tumors of the kidney capsule]. Ann Pathol 1991; 11:266-70

3 Siddiqui NH, Rogalska A,Basil IS Glomangiomyoma (glomus tumor) of the kidney. Arch Pathol Lab Med 2005; 129:1172-4

4 Herawi M, Parwani AV, Edlow D, et al. Glomus tumor of renal pelvis: a case report and review of the literature. Hum Pathol 2005; 36:299-302

This page last revised 30.4.2007.