Antonio D’Antonio, MD, PhD; Maria Addesso, MD; Alessia Caleo, MD; Roberto Altieri, MD; Amedeo Boscaino, MD
Drs. D’Antonio, Caleo, and Altieri are from Azienda Universitaria Ospedaliera San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy. Drs. D’Antonio and Caleo are from the Unit of Anatomic Pathology and Dr. Altieri is from the Unit of Surgery. Dr. Addesso is from the Unit of Anatomic Pathology, M. Scarlato Hospital, Salerno. Dr. Boscaino is from the Unit of Anatomic Pathology, Antonio Cardarelli Hospital, Naples, Italy.
The authors report no conflict of interest.
Correspondence: Antonio D’Antonio, MD, PhD, Unit of Anatomic Pathology, Azienda Universitaria Ospedaliera San Giovanni di Dio e Ruggi d’Aragona, via S Leonardo, Salerno, Italy (ada66@inwind.it).
Distinction between malignant GTs and GTUMPs in the presence of unusual histologic features may be difficult.12 Glomus tumors that do not fulfill criteria for malignancy but have at least 1 atypical feature other than nuclear pleomorphism should be named GTUMPs. According to classification criteria, a true malignant GT is a highly aggressive tumor with metastatic potential. In a case series reported by Folpe et al,2 38% (20/52) of malignant GTs showed metastases, while metastatic disease was not observed in the tumors classified as GTUMPs. Wide surgical excision or Mohs micrographic surgery13 are the treatments of choice for malignant GTs and GTUMPs. Complete excision of the lesion with negative margins is always necessary in cases of GTUMPs. After the diagnosis of GTUMP, adequate follow-up should berecommended due to the possibility of local recurrence or distant metastasis.
Conclusion
Malignant GTs and GTUMPs are rare, and the nomenclature and classification of these tumors is controversial. These findings and the difficulty of differential diagnosis in a continuum between benignity and malignancy prompted our report.