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PHOTO QUIZ
Year : 2012  |  Volume : 57  |  Issue : 3  |  Page : 249-250
An unusually painful nodule


Department of Dermatology, T.N. Medical College and B.Y.L. Nair Ch. Hospital, Mumbai Central, Mumbai, India

Date of Web Publication16-May-2012

Correspondence Address:
Chitra S Nayak
302 Arun, 6th Road, Santacruz (East), Mumbai 400055, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.96229

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How to cite this article:
Pereira RR, Nayak CS, Topal A, Dhurat RS. An unusually painful nodule. Indian J Dermatol 2012;57:249-50

How to cite this URL:
Pereira RR, Nayak CS, Topal A, Dhurat RS. An unusually painful nodule. Indian J Dermatol [serial online] 2012 [cited 2021 May 7];57:249-50. Available from: https://www.e-ijd.org/text.asp?2012/57/3/249/96229


A 36-year-old man presented with a 3-year history of a painful, solitary lesion on the left thigh [Figure 1]. The lesion was exquisitely painful and tender. Cold air aggravated the pain. There was no history of bleeding or discharge. There was history of application of hot oil to relieve the pain which was followed by scarring of the surrounding skin. On examination, there was a solitary papule measuring 5 mm in diameter on medial aspect of the left thigh, surrounded by an annulus of scar tissue.
Figure 1: Solitary papule on left thigh

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Excision biopsy was done. Histopathological examination of H and E stained sections showed a well-circumscribed tumor surrounded by a fibrous stroma in the dermis [Figure 2]. The tumor was composed of sheets of uniform cells with eosinophilic cytoplasm and round to ovoid central nuclei. Numerous dilated, cavernous, thin-walled vascular spaces of varying sizes surrounded by few layers of cells were distributed throughout the tumor [Figure 3] and [Figure 4]. Cytologic atypia was absent.
Figure 2: Well-circumscribed tumor surrounded by a fibrous stroma in the dermis (H and E, ×4)

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Figure 3: Dilated, cavernous, thin-walled vascular spaces of varying sizes throughout the tumor (H and E, ×10)

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Figure 4: Vascular space surrounded by layers of cells (H and E, ×40)

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   Questions Top


Q.1 What is the diagnosis?

Q.2 What are the proposed mechanisms behind its etiopathogenesis?

Q.3 What are the histopathological variants seen in this condition?

Q.4 What are the mimickers of this clinic-pathological entity?

Q.5 How can the condition be managed?



Click here to view answer. View Answer


 
   References Top

1.Calonje E, Mackie R. Soft tissue tumours and tumour-like conditions. In: Burns T, Breathnach S, Cox N and Griffiths C, editors. Rook's textbook of dermatology. 7 th ed. Massachusetts: Blackwell; 2004. p. 31-3.   Back to cited text no. 1
    
2.North P, Kincannon J. Vascular neoplasms and neoplastic-like proliferations. In: Bolognia J, Jorizzo J, Rapini R, editors. 2 nd ed. Spain: Mosby Elsevier; 2008. p. 1790-2.  Back to cited text no. 2
    
3.Schiefer TK, Parker WL, Anakwenze OA, Amadio PC, Inwards CY, Spinner RJ. Extradigital glomus tumors: a 20-year experience. Mayo Clin Proc 2006;81:1337-44.  Back to cited text no. 3
[PUBMED]  [FULLTEXT]  
4.Anakwenze OA, Parker WL, Schiefer TK, Inwards CY, Spinner RJ, Amadio PC. Clinical features of multiple glomus tumors. Dermatol Surg 2008;34:884-90.  Back to cited text no. 4
[PUBMED]  [FULLTEXT]  
5.Gombos Z, Zhang PJ. Glomus Tumor. Arch Pathol Lab Med 2008;132:1448-52.  Back to cited text no. 5
    
6.Calonje E, Wilson-Jones E. Vascular tumors: Tumors and tumor-like conditions of blood vessels and lymphatics. In: Elder D, Elenitsas R, Johnson B, Murphy G, editors. Lever's textbook of histopathology. 7 th ed. Philadelphia: Lippincott Williams and Wilkins; 1990. p. 1049-51.  Back to cited text no. 6
    
7.Ragsdale BD. Tumors with fatty, muscular, osseus, and cartilaginous differentiation. In: Elder D, Elenitsas R, Johnson B, Murphy G, editors. Lever's textbook of histopathology. 7 th ed. Philadelphia: Lippincott Williams and Wilkins; 1990. p. 1079.  Back to cited text no. 7
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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