Barré-Masson glomus angioma (glomus tumor): causes, symptoms, diagnosis, treatment

Glomus angioma of Barre-Masson (syn.: Barre-Masson tumor, glomus tumor, angioneuroma, myoarterial glomus tumor) is a benign oncolog of the organoid type developing from the walls of the Suquet-Goyer canal, which is a functional part of the glomerular arteriovenous anastomosis. It has a narrow lumen lined with endothelial cells and surrounded by several rows of glomus cells. These cells are considered to be modified smooth muscle cells that change the lumen of the anastomosis. The glomeruli are richly innervated. There are two types of glomus angioma: solitary and multiple. The most common is the solitary type, which is a purple nodule 0.3-0.8 cm in diameter, soft in consistency, clearly demarcated, sharply painful, located deep in the dermis. Localized most often on the extremities, especially near the nail bed. Multiple glomus angiomas are less common, they are almost painless, located inside the skin or subcutaneously. They occur more often in childhood, mainly in boys, and can be combined with lesions of internal organs.

Pathomorphology of Barre-Masson glomus angioma (glomus tumor). A solitary glomus angioma node consists of a large number of small vessels, the lumens of which are lined with a single layer of flattened endotheliocytes. To the periphery of them, glomus cells are located in several layers, having a weakly eosinophilic cytoplasm and large oval nuclei, darkly stained with hematoxylin, resembling epithelial elements. In many areas, their polymorphism is noted, as well as dystrophic changes. The tumor stroma is scanty, represented by argyrophilic fibers and thin collagen bundles, sometimes hyalinized. When impregnated with silver nitrate, a large number of nerve fibers are revealed, most often unmyelinated.

Multiple glomus angiomas do not have a capsule and consist of larger vascular clefts of irregular shape. Just as in a solitary node, the vascular clefts are lined with a single layer of flattened endothelial cells, but the number of glomus cells located to the periphery of the endothelial cells is significantly smaller, and in some places they are absent. There is no increase in the number of nerve fibers. This structure resembles the structure of a cavernous hemangioma.

Histogenesis of Barré-Masson glomus angioma (glomus tumor). Both types of glomus angioma are associated with the arterial segment of the cutaneous glomus, or Suquet-Goyer canal. On electron microscopy, normal glomus cells are smooth muscle cells. The glomus cells of the tumor are also smooth muscle cells in both solitary and multiple types of tumor. However, the smooth muscle cells in glomus angioma are polygonal rather than spindle-shaped. These cells are surrounded by a fibrous basement membrane, which also separates the glomus cells from the endothelial cells. The glomus cells contain a large number of filaments arranged in bundles.

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