Glomangiomatosis of the sural nerve

Glomus tumours are rare soft tissue tumours that originate from (or differentiate along the lines of) the normal glomus body. Although the normal glomus body is found exclusively in the skin and coccygeal region (glomus coccygeum), glomus tumours have been reported in a wide variety of soft tissue and visceral locations.1 ,2 Intraneural glomus tumours, however, are quite rare, with only 10 previously reported cases (reviewed in3 ,4). WHO currently classifies glomus tumours as (1) typical glomus tumours, (2) glomovenous malformations (glomangiomas), (3) symplastic glomus tumours, (4) malignant glomus tumours and (5) glomangiomatosis.1 Glomangiomatosis is the least common variant of glomus tumour and consists of an infiltrative proliferation of abnormally configured blood vessels resembling angiomatosis (diffuse haemangioma),5 with nests of glomus cells investing the vessel walls.1 ,6 To date, only a very small number of cases of glomangiomatosis have been reported (reviewed in7); none have involved the peripheral nerve. Herein, we report a 56-year-old man with glomangiomatosis involving the sural nerve. Tissue obtained from the biopsy of the right sural nerve was routinely processed and H&E and periodic acid Schiff’s with diastase digestion (PAS-D) stains were performed. Immunohistochemistry for smooth muscle actin was performed on formalin-fixed tissue, using our standard laboratory protocols. A 56-year-old man developed sudden onset of …