18F-FDG PET/CT and MRI findings of an atypical glomus tumor of the thoracic spine: a rare case report.

BACKGROUND

Glomus tumors (glomangiomas) are rare mesenchymal neoplasms derived from modified smooth muscle cells of the glomus body. Since they most commonly occur in the subungual regions of the extremities, primary involvement of the spine is exceedingly rare, particularly in atypical variants with borderline biological behavior.

CASE PRESENTATION: A 61-year-old man presented with a long-standing history of intermittent back pain that had recently worsened. Magnetic resonance imaging revealed a solid lesion involving the T10-T11 vertebral region with intermediate T1 signal intensity, mildly hypointense T2 signal, intralesional hemorrhagic foci, and marked heterogeneous enhancement causing spinal canal stenosis. 18F-FDG PET/CT demonstrated mild to moderate focal radiotracer uptake (SUVmax 5.6) corresponding to the spinal lesion, without evidence of other FDG-avid lesions suggestive of a primary malignancy or metastatic disease. Surgical resection was primarily indicated based on progressive symptoms and MRI findings; PET/CT findings did not alter the surgical decision but provided additional staging information, and histopathological examination established the diagnosis of an atypical glomus tumor.

CONCLUSION

This case highlights the complementary role of MRI and 18F-FDG PET/CT in the evaluation of rare spinal glomus tumors. 18F-FDG PET/CT may provide supportive metabolic information and help assess the presence of additional FDG-avid lesions in atypical presentations.