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TMA &#40;3&#8239;&#956;m thickness&#41; was sliced with an automatic paraffin section system&#46; Immunohistochemistry was performed after sectioning&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Immunostaining</span><p id="par0020" class="elsevierStylePara elsevierViewall">All pathological samples were sectioned&#46; The sections were deparaffinized and rehydrated using xylene and graded alcohol&#46; The sections were then blocked with 2&#37; bovine serum albumin&#44; incubated with IL-1 Beta Polyclonal Rabbit Polyclonal Antibody &#40;China&#44; Servicebio&#44;16806-1-AP&#41; at a dilution of 1&#58;200&#59; Anti-IL-6 Rabbit pAb &#40;China&#44; Servicebio&#44;Gb1117&#41; at a dilution of 1&#58;800&#59; Anti-CGRP antibody &#40;China&#44; Servicebio&#44; 16630-1-AP&#41; at a dilution of 1&#58;200 for 2&#8239;hours&#44; followed by incubation with biotinylated secondary antibodies for 1&#46;5&#8239;hours and then horseradish peroxidase-bound streptavidin&#46; Subsequently&#44; 3-amino-9-ethylcarbazole was added dropwise over 3&#8210;5&#8202;minutes&#44; and sections were counterstained with hematoxylin&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Sample assessment</span><p id="par0025" class="elsevierStylePara elsevierViewall">Immunohistochemical results of IL-1&#946;&#44; IL-6 and CGRP in GT were recorded to determine the differences between the groups&#46; The three tissue chips were electronically scanned&#44; observed&#44; and analyzed using CaseViewer&#46; IL-1&#946;- and IL-6-positive staining was cytoplasmic&#46; The results were expressed by combining the dyeing strength and percent as described&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The dyeing strength was scored as follows&#58; 0&#8210;no staining&#44; 1&#8210;weak staining&#44; 2&#8210;medium staining&#44; and 3&#8210;strong staining&#46; The dyeing percent was scored as follows&#58; 0-point&#58; 0&#37; to 5&#37; of the total cells were stained&#59; 1-point&#58; 6&#37; to 25&#37; staining&#59; 2-points&#58; 26&#37; to 50&#37; staining&#59; 3-points&#58; 51&#37; to 75&#37; staining&#44; and 4-points&#58; &#62;75&#37;&#46; Results were presented as based upon the product of staining intensity and percent&#58; 0 &#8210; negative &#40;-&#41;&#59; 1 to 7 &#8211; weakly positive &#40;&#43;&#41;&#59; 8 to 10 &#8211; medium positive &#40;&#43;&#43;&#41;&#59; and 11 to 12 &#8211; strongly positive &#40;&#43;&#43;&#43;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Analysis was performed using IBM SPSS 26 program &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#41;&#46; Statistical tests included Mann-Whitney <span class="elsevierStyleItalic">U</span> test&#46; A p&#60;0&#46;05 was required for the results to be considered statistically significant&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Clinicopathologic characteristics of 60&#8239;GTs &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Pathological morphology of GT</span><p id="par0035" class="elsevierStylePara elsevierViewall">Different pathological forms of GT contain glomus cells&#44; vascular lumen&#44; and vascular smooth muscle cells&#44; but the proportion is different&#46; Solid glomus tumor is mostly composed of glomus cells&#44; glomangioma is composed of glomus cells surrounding a large number of blood vessels&#44; and a large number of vascular smooth muscle cells can be seen in glomangiomyoma&#46; In this study&#44; only two pathological types of solid glomus tumor and glomangioma were found &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Expression of IL-1&#946;&#44; IL-6 and CGRP in GT</span><p id="par0040" class="elsevierStylePara elsevierViewall">Immunohistochemically&#44; tumor cells in all 60 cases showed diffuse immunostaining for IL-1&#946; and IL-6 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> A&#8210;B&#41;&#46; And there was no noticeable difference in staining intensity between IL-1&#946; and IL-6 &#40;<span class="elsevierStyleItalic">Z</span>&#8239;&#61;&#8239;-0&#46;750&#44; p&#8239;&#61;&#8239;0&#46;492&#41;&#46; There was no difference in the expression of IL-1&#946; in different histological types of GT &#40;<span class="elsevierStyleItalic">Z</span>&#8239;&#61;&#8239;-1&#46;567&#44; p&#8239;&#61;&#8239;0&#46;155&#41;&#44; and neither was IL-6 &#40;<span class="elsevierStyleItalic">Z</span>&#8239;&#61;&#8239;-0&#46;685&#44; p&#8239;&#61;&#8239;0&#46;452&#41;&#46; CGRP was not expressed in GT &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Two of the 60&#8239;GT patients were asymptomatic&#44; and the expression of IL-1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; and IL-6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; were moderately or strongly positive&#46; Four patients who complained of cold sensitivity had strongly positive diffuse staining for IL-1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; and IL-6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; The expression of IL-1&#946; did not differ between the pain cases with or without cold intolerance &#40;Z&#8239;&#61;&#8239;-0&#46;989&#44; p&#8239;&#61;&#8239;0&#46;580&#41;&#46; Neither did IL-6 &#40;Z&#8239;&#61;&#8239;-0&#46;878&#44; p&#8239;&#61;&#8239;0&#46;609&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Current studies on GT mostly were case reports&#46; The present study describes the clinicopathologic features by a retrospective case series study of 60&#8239;GT&#46; There were more female patients&#44; and the ratio of males to was near 1&#58;2 &#40;21&#58;39&#41;&#44; which was consistent with previous research&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> GT is more common in young and middle-aged people&#44; and they usually have longer disease duration&#46; All patients in this study had a single lesion&#46; More than half of 60 cases were located in digits&#44; especially the thumbs of both hands&#46; The distal phalanx is the most common painful localization&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> The glomus body is a thermoregulatory neurovascular structure&#46; So&#44; when the temperature changes&#44; the intracapsular pressure of the tumor changes and causes pain&#46; Clinically&#44; GT may occur in other organs such as the stomach&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> kidney&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> segmental bronchus<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> and so on&#46; Although rare&#44; the number of reports has grown in recent years&#46; The etiology of GT is unknown&#44; but there were researchers pointed out neurofibromatosis type 1 patients are often accompanied by GT&#44; and neurofibromatosis type 1 mutations on both alleles were found in glomus cells&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> There were no cases of neurofibromatosis in this study&#44; and no other concomitant-specific diseases were found&#46; The mean size of the tumor is 0&#46;79&#8239;cm&#44; the maximum tumor length is 3&#8239;cm&#46;GT is usually benign and would not continue to increase in size indefinitely&#46; 58 cases exhibited pain&#44; and only 2 cases were asymptomatic&#44; this may be due to individual differences&#44; as each person has a different perception and threshold for pain&#46; The majority of pathological types were solid glomus tumor and glomangioma&#44; there was no glomangiomyoma&#44; it was consistent with the previous study&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> The initial diagnosis included glomus tumor&#44; vascular tumor&#44; cysts and swelling&#44; the rate of correct diagnoses was 63&#46;3&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Pinpoint tenderness&#44; severe pain&#44; and cold hypersensitivity are typical clinical manifestations of GT&#44; although they may not be present at the same time&#46; Few research explored the mechanism of pain in GT&#46; <a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;14</span></a> The typical pain triad of GT is like that of neuropathic pain&#58; spontaneous pain&#44; hyperalgesia&#44; and evoked pain &#40;particularly to light touch and cold&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> The authors believe that the pain caused by GT is neuropathic pain&#46; The mechanism of neuropathic pain is complex&#44; involving central sensitization and peripheral sensitization&#46; IL-1&#946; and IL-6 are two kinds of pain mediators&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Previous studies showed that IL-1&#946; could induce neuropathic pain and inflammation&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> and reducing its expression can reduce pain&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In the red nucleus&#44; IL-6 mediates neuropathic pain by inducing the production of TNF-&#945; and IL-1&#946;&#46; IL-6 induces the production of IL-1&#946; through the JAK2&#47;STAT3 and ERK pathways&#46; Neuronal pain or pain after nerve injury heavily depends on cytokine signal transduction &#40;particularly IL-1&#946;&#41;&#46; The intrathecal concentration of IL-1&#946; correlated with the degree of abnormal mechanical pain&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> IL-1&#946; itself&#44; via auto-stimulation in endothelial cells&#44; is the mechanism of sustained IL-1&#946; overexpression&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> GT is formed by the pathological proliferation of the glomus body&#44; which is composed of endothelial cells&#44; therefore&#44; IL-1&#946; may be related to the pathogenesis of GT&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">IL-6 is upregulated in various preclinical models of neuropathic pain&#44; including peripheral injury&#44; cancer pain&#44; and diabetic peripheral neuropathy&#46; IL-6 levels in patients with herpes zoster are significantly increased&#44; related to pain severity&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> After nerve injury&#44; IL-6 levels are associated with allodynia due to the increased synthesis of neurons or immune cells&#46; IL-6 interacts with neurons in the pain pathway and induces excessive excitability of nociceptors&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The neuropeptide CGRP is the principal neurotransmitter of class C nerve fiber&#44; serving an essential role in initiating and maintaining neuropathic pain&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> The present study found that CGRP was not expressed in GT&#44; suggesting that CGRP may not play a significant role in GT-related pain&#46; The release or expression of CGRP is one of the key factors in pain&#46; CGRP concentrations in plasma&#44; synovial fluid&#44; and cerebrospinal fluid are elevated during pain&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> but the expression of CGRP in tissues has been poorly studied and the exact mechanism has not been fully described&#46; There are no studies on the correlation between CGRP and GT&#46; The role of CGRP in pain is more reflected in diseases such as migraines&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> GT is a small local superficial tumor&#44; and the specific role of CGRP in different diseases may be different&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The authors found that expression of IL-1&#946; and IL-6 was high in GT cells&#44; suggesting that IL-1&#946; and IL-6 have certain nociceptive roles in GT&#46; Pinpoint tenderness and severe pain often coexist&#46; In the four patients with cold intolerance&#44; the intensity of IL-1&#946; and IL-6 staining was also strong&#44; suggesting that they may not play a role in the cold hypersensitivity&#46; However&#44; since there are only 4 patients with cold intolerance&#44; it&#8217;s necessary to research further in a larger sample size&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0080" class="elsevierStylePara elsevierViewall">GT is rare in clinics and is more common in women&#46; Its appearance is sometimes difficult to distinguish from hemangioma or epidermal cyst&#46; Diagnosis should be based on clinical manifestations combined with histopathological examination&#46; Most patients are accompanied by allodynia&#44; and a few patients have cold-sensitive pain&#46;IL-1&#946; and IL-6 were expressed in all GT cases&#44; suggesting that they might participate in the pain mechanism&#44; but not the cause of cold hypersensitivity&#46; CGRP has not been found to play any role in it yet&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Financial support</span><p id="par0085" class="elsevierStylePara elsevierViewall">This work was supported by the <span class="elsevierStyleGrantSponsor" id="gs0005">National Natural Science Foundation of China</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs0005">21874014</span>&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Author&#8217;s contribution</span><p id="par0095" class="elsevierStylePara elsevierViewall">Yuehua Sun&#58; Data collection&#44; analysis and interpretation&#44; Preparation and writing of the manuscript&#44; Statistical analysis&#44; Approval of the final version of the manuscript</p><p id="par0100" class="elsevierStylePara elsevierViewall">Ruiqun Qi&#58; Effective participation in research orientation&#44; Study conception and planning&#44; Approval of the final version of the manuscript</p><p id="par0105" class="elsevierStylePara elsevierViewall">Ze Wu&#58; Critical literature review&#44; Approval of the final version of the manuscript</p><p id="par0110" class="elsevierStylePara elsevierViewall">Xiaodong Zhang&#58; Intellectual participation in propaedeutic and&#47;or therapeutic management of studied cases&#44; Manuscript critical review&#44; Approval of the final version of the manuscript</p><p id="par0115" class="elsevierStylePara elsevierViewall">Jun Niu&#58; Approval of the final version of the manuscript&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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          "titulo" => "Introduction"
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          "titulo" => "Materials and methods"
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              "titulo" => "Clinicopathologic characteristics of 60&#8239;GTs &#40;Table 1&#41;"
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            1 => "Glomus tumor"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Glomus Tumor &#40;GT&#41; are benign neoplasms that originate from mesenchymal cells&#46; It presents as tenderness and cold allodynia in the digits&#44; especially in the subungual region&#46; There are a few studies that investigated the mechanism of pain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To analyze the clinical-pathologic characteristics of GT and to identify the expression of IL-1&#946;&#44; IL-6&#44; and CGRP in it&#44; further&#44; to explore the possible mechanism of pain&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The clinical and pathological data of 60&#8239;GT patients were retrospectively analyzed&#46; Tissue microarrays and immunohistochemistry were used to measure the expression of IL-1&#946;&#44; IL-6 and CGRP&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">GT is more common in females and the ratio of male to was near to 1&#58;2&#44; mostly in middle-aged people&#46; It often occurs in fingertips&#44; especially the thumbs&#46; Patients often present with spontaneous pain&#44; tenderness&#44; and cold hypersensitivity&#46; Both the two pain mediators IL-1&#946; and IL-6 were highly expressed in GT cells of patients with and without cold hypersensitivity&#46; While CGRP was not expressed in GT&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Low sample size and further research is needed to explore the specific mechanism&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">IL-1&#946; and IL-6 were highly expressed in GT cells&#44; suggesting that IL-1&#946; and IL-6 have certain nociceptive roles in GT&#46; In the 4 patients with cold intolerance&#44; the intensity of IL-1&#946; and IL-6 staining was also strong&#44; suggesting that they may not play a role in the cold hypersensitivity&#46; However&#44; since there are only 4 patients with cold intolerance&#44; it&#8217;s necessary to conduct further in-depth research using a larger sample size&#46; The specific role of CGRP in GT has not been found yet&#46;</p></span>"
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          0 => array:3 [
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            "detalle" => "Figure "
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">IL-1&#946; expression&#58; &#40;A&#41; moderate expression in asymptomatic glomus cells &#40;&#215;200&#41;&#59; &#40;B&#41; strong expression in allodynia glomus cells &#40;&#215;200&#41;&#59; &#40;C&#41; moderate expression in cold-sensitive glomus cells &#40;&#215;200&#41;&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
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        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
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            "Ancho" => 1675
            "Tamanyo" => 1576554
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          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
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          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">IL-6 expression&#58; &#40;A&#41; strong expression in asymptomatic glomus cells &#40;&#215;200&#41;&#59; &#40;B&#41; strong expression in allodynia glomus cells &#40;&#215;200&#41;&#59; &#40;C&#41; strong expression in cold-sensitive glomus cells &#40;&#215;200&#41;&#46;</p>"
        ]
      ]
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        "identificador" => "tbl0005"
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        "tipo" => "MULTIMEDIATABLA"
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            "identificador" => "at0025"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Gender&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&#58;Female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age at diagnosis&#44; years</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean &#40;Range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40 &#40;8&#8210;92&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Duration&#44; years</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean &#40;Range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;31 &#40;10 days&#8210;30 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Location&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Digit&#44; Extradigit&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&#58;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hands and toes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Arms and legs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Trunk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Face&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left hand&#44; right hand&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Thumb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#58;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Index finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Middle finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Index finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#58;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ring finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#58;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Palm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#58;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Under nail&#44; Skin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Size&#44; cm</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean &#40;Range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79 &#40;0&#46;1&#8210;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pain &#40;Cold intolerance&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Painless&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pathology&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Solid glomus tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomangioma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomangiomyoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Initial diagnosis&#44; n &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomus tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;63&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vascular tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;13&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cystis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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Original Article
The clinicopathologic and immunohistochemical features of 60 cutaneous glomus tumor: a retrospective case series study
Yuehua Suna, Ruiqun Qib, Ze Wua, Xiaodong Zhanga, Jun Niua,
Corresponding author
niujun06@yeah.net

Corresponding author.
a Department of Dermatology, General Hospital of Northern Theater Command, Shenyang, China
b Key Laboratory of Immunodermatology, Ministry of Education, NHC, National and Local Joint Engineering Research Center of Immunodermatological Theranostics, The First Hospital of China Medical University, Shenyang, China
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Representative images of immunohistochemical staining from glomus tumor samples&#46; &#40;A&#41; IL-1&#946; was strongly expressed in glomus cells &#40;&#215;200&#41;&#59; &#40;B&#41; IL-6 was strongly expressed in glomus cells &#40;&#215;200&#41;&#59; &#40;C&#41; CGRP was not expressed in glomus cells &#40;&#215;200&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Glomus Tumor &#40;GT&#41; is a benign neoplasm of mesenchymal origin tumor arising from the glomus body&#46; It generally occurs in the fingers&#44; especially the nailbeds&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> GT is often misdiagnosed&#44; leading to pain and delay in treatment&#46; Allodynia&#44; localized tenderness&#44; and cold hypersensitivity are the key to diagnosing GT&#46; However&#44; patients do not always show these symptoms simultaneously in practice&#46; Although previous studies showed that nerve fibers&#44; mast cells and cyclooxygenase-2 are abundant in GT&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a> an understanding of pain mechanisms is still incomplete&#46; In this study&#44; a retrospective case series study of 60 patients with GT was performed&#46; The authors examined the expression of Interleukin-1Beta &#40;IL-1&#946;&#41;&#44; Interleukin-6 &#40;IL-6&#41;&#44; and Calcitonin Gene Related Peptide &#40;CGRP&#41; in GT tissues and analyzed their possible role in GT&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Materials and methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Samples collection of glomus tumor</span><p id="par0010" class="elsevierStylePara elsevierViewall">The data of 60&#8239;GT cases were collected&#44; all of whom visited the General Hospital of Northern Theater Command from 2002 to 2019 and were diagnosed as GT by routine pathological examination &#40;Hematoxylin and eosin staining&#41;&#46; The clinical data were retrieved from the electronic case system&#46; All cases were reconfirmed by two dermatopathologists&#46; There are three types of GT based on the proportions of glomus cells&#44; vascular structures&#44; and smooth muscle&#58; solid glomus tumor&#44; glomangioma&#44; and glomangiomyoma&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Tissue microarrays &#40;TMA&#41;</span><p id="par0015" class="elsevierStylePara elsevierViewall">Paraffin blocks and sections of the 60&#8239;GT samples were collected and were assessed microscopically&#46; A 1&#8210;2&#8239;mm point within each section was selected&#44; and a semi-automatic tissue drill was used to isolate a tissue cylinder &#40;1&#8210;2&#8239;mm in diameter&#41; or in the center of the donor block&#44; where glomus tumor cells were intensively located&#46; These isolated samples were then inserted into 1 new paraffin block for TMA&#46; TMA &#40;3&#8239;&#956;m thickness&#41; was sliced with an automatic paraffin section system&#46; Immunohistochemistry was performed after sectioning&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Immunostaining</span><p id="par0020" class="elsevierStylePara elsevierViewall">All pathological samples were sectioned&#46; The sections were deparaffinized and rehydrated using xylene and graded alcohol&#46; The sections were then blocked with 2&#37; bovine serum albumin&#44; incubated with IL-1 Beta Polyclonal Rabbit Polyclonal Antibody &#40;China&#44; Servicebio&#44;16806-1-AP&#41; at a dilution of 1&#58;200&#59; Anti-IL-6 Rabbit pAb &#40;China&#44; Servicebio&#44;Gb1117&#41; at a dilution of 1&#58;800&#59; Anti-CGRP antibody &#40;China&#44; Servicebio&#44; 16630-1-AP&#41; at a dilution of 1&#58;200 for 2&#8239;hours&#44; followed by incubation with biotinylated secondary antibodies for 1&#46;5&#8239;hours and then horseradish peroxidase-bound streptavidin&#46; Subsequently&#44; 3-amino-9-ethylcarbazole was added dropwise over 3&#8210;5&#8202;minutes&#44; and sections were counterstained with hematoxylin&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Sample assessment</span><p id="par0025" class="elsevierStylePara elsevierViewall">Immunohistochemical results of IL-1&#946;&#44; IL-6 and CGRP in GT were recorded to determine the differences between the groups&#46; The three tissue chips were electronically scanned&#44; observed&#44; and analyzed using CaseViewer&#46; IL-1&#946;- and IL-6-positive staining was cytoplasmic&#46; The results were expressed by combining the dyeing strength and percent as described&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The dyeing strength was scored as follows&#58; 0&#8210;no staining&#44; 1&#8210;weak staining&#44; 2&#8210;medium staining&#44; and 3&#8210;strong staining&#46; The dyeing percent was scored as follows&#58; 0-point&#58; 0&#37; to 5&#37; of the total cells were stained&#59; 1-point&#58; 6&#37; to 25&#37; staining&#59; 2-points&#58; 26&#37; to 50&#37; staining&#59; 3-points&#58; 51&#37; to 75&#37; staining&#44; and 4-points&#58; &#62;75&#37;&#46; Results were presented as based upon the product of staining intensity and percent&#58; 0 &#8210; negative &#40;-&#41;&#59; 1 to 7 &#8211; weakly positive &#40;&#43;&#41;&#59; 8 to 10 &#8211; medium positive &#40;&#43;&#43;&#41;&#59; and 11 to 12 &#8211; strongly positive &#40;&#43;&#43;&#43;&#41;&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Analysis was performed using IBM SPSS 26 program &#40;SPSS Inc&#46;&#44; Chicago&#44; IL&#41;&#46; Statistical tests included Mann-Whitney <span class="elsevierStyleItalic">U</span> test&#46; A p&#60;0&#46;05 was required for the results to be considered statistically significant&#46;</p></span></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Clinicopathologic characteristics of 60&#8239;GTs &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Pathological morphology of GT</span><p id="par0035" class="elsevierStylePara elsevierViewall">Different pathological forms of GT contain glomus cells&#44; vascular lumen&#44; and vascular smooth muscle cells&#44; but the proportion is different&#46; Solid glomus tumor is mostly composed of glomus cells&#44; glomangioma is composed of glomus cells surrounding a large number of blood vessels&#44; and a large number of vascular smooth muscle cells can be seen in glomangiomyoma&#46; In this study&#44; only two pathological types of solid glomus tumor and glomangioma were found &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Expression of IL-1&#946;&#44; IL-6 and CGRP in GT</span><p id="par0040" class="elsevierStylePara elsevierViewall">Immunohistochemically&#44; tumor cells in all 60 cases showed diffuse immunostaining for IL-1&#946; and IL-6 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> A&#8210;B&#41;&#46; And there was no noticeable difference in staining intensity between IL-1&#946; and IL-6 &#40;<span class="elsevierStyleItalic">Z</span>&#8239;&#61;&#8239;-0&#46;750&#44; p&#8239;&#61;&#8239;0&#46;492&#41;&#46; There was no difference in the expression of IL-1&#946; in different histological types of GT &#40;<span class="elsevierStyleItalic">Z</span>&#8239;&#61;&#8239;-1&#46;567&#44; p&#8239;&#61;&#8239;0&#46;155&#41;&#44; and neither was IL-6 &#40;<span class="elsevierStyleItalic">Z</span>&#8239;&#61;&#8239;-0&#46;685&#44; p&#8239;&#61;&#8239;0&#46;452&#41;&#46; CGRP was not expressed in GT &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>C&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Two of the 60&#8239;GT patients were asymptomatic&#44; and the expression of IL-1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; and IL-6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; were moderately or strongly positive&#46; Four patients who complained of cold sensitivity had strongly positive diffuse staining for IL-1&#946; &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; and IL-6 &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#46; The expression of IL-1&#946; did not differ between the pain cases with or without cold intolerance &#40;Z&#8239;&#61;&#8239;-0&#46;989&#44; p&#8239;&#61;&#8239;0&#46;580&#41;&#46; Neither did IL-6 &#40;Z&#8239;&#61;&#8239;-0&#46;878&#44; p&#8239;&#61;&#8239;0&#46;609&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Current studies on GT mostly were case reports&#46; The present study describes the clinicopathologic features by a retrospective case series study of 60&#8239;GT&#46; There were more female patients&#44; and the ratio of males to was near 1&#58;2 &#40;21&#58;39&#41;&#44; which was consistent with previous research&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> GT is more common in young and middle-aged people&#44; and they usually have longer disease duration&#46; All patients in this study had a single lesion&#46; More than half of 60 cases were located in digits&#44; especially the thumbs of both hands&#46; The distal phalanx is the most common painful localization&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> The glomus body is a thermoregulatory neurovascular structure&#46; So&#44; when the temperature changes&#44; the intracapsular pressure of the tumor changes and causes pain&#46; Clinically&#44; GT may occur in other organs such as the stomach&#44;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> kidney&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> segmental bronchus<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> and so on&#46; Although rare&#44; the number of reports has grown in recent years&#46; The etiology of GT is unknown&#44; but there were researchers pointed out neurofibromatosis type 1 patients are often accompanied by GT&#44; and neurofibromatosis type 1 mutations on both alleles were found in glomus cells&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> There were no cases of neurofibromatosis in this study&#44; and no other concomitant-specific diseases were found&#46; The mean size of the tumor is 0&#46;79&#8239;cm&#44; the maximum tumor length is 3&#8239;cm&#46;GT is usually benign and would not continue to increase in size indefinitely&#46; 58 cases exhibited pain&#44; and only 2 cases were asymptomatic&#44; this may be due to individual differences&#44; as each person has a different perception and threshold for pain&#46; The majority of pathological types were solid glomus tumor and glomangioma&#44; there was no glomangiomyoma&#44; it was consistent with the previous study&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> The initial diagnosis included glomus tumor&#44; vascular tumor&#44; cysts and swelling&#44; the rate of correct diagnoses was 63&#46;3&#37;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Pinpoint tenderness&#44; severe pain&#44; and cold hypersensitivity are typical clinical manifestations of GT&#44; although they may not be present at the same time&#46; Few research explored the mechanism of pain in GT&#46; <a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;14</span></a> The typical pain triad of GT is like that of neuropathic pain&#58; spontaneous pain&#44; hyperalgesia&#44; and evoked pain &#40;particularly to light touch and cold&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> The authors believe that the pain caused by GT is neuropathic pain&#46; The mechanism of neuropathic pain is complex&#44; involving central sensitization and peripheral sensitization&#46; IL-1&#946; and IL-6 are two kinds of pain mediators&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Previous studies showed that IL-1&#946; could induce neuropathic pain and inflammation&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> and reducing its expression can reduce pain&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> In the red nucleus&#44; IL-6 mediates neuropathic pain by inducing the production of TNF-&#945; and IL-1&#946;&#46; IL-6 induces the production of IL-1&#946; through the JAK2&#47;STAT3 and ERK pathways&#46; Neuronal pain or pain after nerve injury heavily depends on cytokine signal transduction &#40;particularly IL-1&#946;&#41;&#46; The intrathecal concentration of IL-1&#946; correlated with the degree of abnormal mechanical pain&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> IL-1&#946; itself&#44; via auto-stimulation in endothelial cells&#44; is the mechanism of sustained IL-1&#946; overexpression&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> GT is formed by the pathological proliferation of the glomus body&#44; which is composed of endothelial cells&#44; therefore&#44; IL-1&#946; may be related to the pathogenesis of GT&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">IL-6 is upregulated in various preclinical models of neuropathic pain&#44; including peripheral injury&#44; cancer pain&#44; and diabetic peripheral neuropathy&#46; IL-6 levels in patients with herpes zoster are significantly increased&#44; related to pain severity&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> After nerve injury&#44; IL-6 levels are associated with allodynia due to the increased synthesis of neurons or immune cells&#46; IL-6 interacts with neurons in the pain pathway and induces excessive excitability of nociceptors&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The neuropeptide CGRP is the principal neurotransmitter of class C nerve fiber&#44; serving an essential role in initiating and maintaining neuropathic pain&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> The present study found that CGRP was not expressed in GT&#44; suggesting that CGRP may not play a significant role in GT-related pain&#46; The release or expression of CGRP is one of the key factors in pain&#46; CGRP concentrations in plasma&#44; synovial fluid&#44; and cerebrospinal fluid are elevated during pain&#44;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> but the expression of CGRP in tissues has been poorly studied and the exact mechanism has not been fully described&#46; There are no studies on the correlation between CGRP and GT&#46; The role of CGRP in pain is more reflected in diseases such as migraines&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> GT is a small local superficial tumor&#44; and the specific role of CGRP in different diseases may be different&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">The authors found that expression of IL-1&#946; and IL-6 was high in GT cells&#44; suggesting that IL-1&#946; and IL-6 have certain nociceptive roles in GT&#46; Pinpoint tenderness and severe pain often coexist&#46; In the four patients with cold intolerance&#44; the intensity of IL-1&#946; and IL-6 staining was also strong&#44; suggesting that they may not play a role in the cold hypersensitivity&#46; However&#44; since there are only 4 patients with cold intolerance&#44; it&#8217;s necessary to research further in a larger sample size&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conclusions</span><p id="par0080" class="elsevierStylePara elsevierViewall">GT is rare in clinics and is more common in women&#46; Its appearance is sometimes difficult to distinguish from hemangioma or epidermal cyst&#46; Diagnosis should be based on clinical manifestations combined with histopathological examination&#46; Most patients are accompanied by allodynia&#44; and a few patients have cold-sensitive pain&#46;IL-1&#946; and IL-6 were expressed in all GT cases&#44; suggesting that they might participate in the pain mechanism&#44; but not the cause of cold hypersensitivity&#46; CGRP has not been found to play any role in it yet&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Financial support</span><p id="par0085" class="elsevierStylePara elsevierViewall">This work was supported by the <span class="elsevierStyleGrantSponsor" id="gs0005">National Natural Science Foundation of China</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs0005">21874014</span>&#41;&#46;</p></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Author&#8217;s contribution</span><p id="par0095" class="elsevierStylePara elsevierViewall">Yuehua Sun&#58; Data collection&#44; analysis and interpretation&#44; Preparation and writing of the manuscript&#44; Statistical analysis&#44; Approval of the final version of the manuscript</p><p id="par0100" class="elsevierStylePara elsevierViewall">Ruiqun Qi&#58; Effective participation in research orientation&#44; Study conception and planning&#44; Approval of the final version of the manuscript</p><p id="par0105" class="elsevierStylePara elsevierViewall">Ze Wu&#58; Critical literature review&#44; Approval of the final version of the manuscript</p><p id="par0110" class="elsevierStylePara elsevierViewall">Xiaodong Zhang&#58; Intellectual participation in propaedeutic and&#47;or therapeutic management of studied cases&#44; Manuscript critical review&#44; Approval of the final version of the manuscript</p><p id="par0115" class="elsevierStylePara elsevierViewall">Jun Niu&#58; Approval of the final version of the manuscript&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conflicts of interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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              "titulo" => "Clinicopathologic characteristics of 60&#8239;GTs &#40;Table 1&#41;"
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                  "titulo" => "Pathological morphology of GT"
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    "fechaRecibido" => "2023-01-24"
    "fechaAceptado" => "2023-03-24"
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          "clase" => "keyword"
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            0 => "Calcitonin gene-related peptide"
            1 => "Glomus tumor"
            2 => "Interleukin-1beta"
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    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Glomus Tumor &#40;GT&#41; are benign neoplasms that originate from mesenchymal cells&#46; It presents as tenderness and cold allodynia in the digits&#44; especially in the subungual region&#46; There are a few studies that investigated the mechanism of pain&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To analyze the clinical-pathologic characteristics of GT and to identify the expression of IL-1&#946;&#44; IL-6&#44; and CGRP in it&#44; further&#44; to explore the possible mechanism of pain&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The clinical and pathological data of 60&#8239;GT patients were retrospectively analyzed&#46; Tissue microarrays and immunohistochemistry were used to measure the expression of IL-1&#946;&#44; IL-6 and CGRP&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">GT is more common in females and the ratio of male to was near to 1&#58;2&#44; mostly in middle-aged people&#46; It often occurs in fingertips&#44; especially the thumbs&#46; Patients often present with spontaneous pain&#44; tenderness&#44; and cold hypersensitivity&#46; Both the two pain mediators IL-1&#946; and IL-6 were highly expressed in GT cells of patients with and without cold hypersensitivity&#46; While CGRP was not expressed in GT&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Low sample size and further research is needed to explore the specific mechanism&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">IL-1&#946; and IL-6 were highly expressed in GT cells&#44; suggesting that IL-1&#946; and IL-6 have certain nociceptive roles in GT&#46; In the 4 patients with cold intolerance&#44; the intensity of IL-1&#946; and IL-6 staining was also strong&#44; suggesting that they may not play a role in the cold hypersensitivity&#46; However&#44; since there are only 4 patients with cold intolerance&#44; it&#8217;s necessary to conduct further in-depth research using a larger sample size&#46; The specific role of CGRP in GT has not been found yet&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Light Microscopy of glomus tumor&#46; &#40;A&#41; Solid glomus tumor was composed of monotonous round cells in solid sheets&#46; &#40;B&#41; Glomangioma showed a large number of vascular lumens&#44; which were surrounded by several layers of glomus cells&#46; &#40;Hematoxylin &#38; eosin&#44; &#215;100&#41;&#46;</p>"
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          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Representative images of immunohistochemical staining from glomus tumor samples&#46; &#40;A&#41; IL-1&#946; was strongly expressed in glomus cells &#40;&#215;200&#41;&#59; &#40;B&#41; IL-6 was strongly expressed in glomus cells &#40;&#215;200&#41;&#59; &#40;C&#41; CGRP was not expressed in glomus cells &#40;&#215;200&#41;&#46;</p>"
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          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">IL-1&#946; expression&#58; &#40;A&#41; moderate expression in asymptomatic glomus cells &#40;&#215;200&#41;&#59; &#40;B&#41; strong expression in allodynia glomus cells &#40;&#215;200&#41;&#59; &#40;C&#41; moderate expression in cold-sensitive glomus cells &#40;&#215;200&#41;&#46;</p>"
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                  \t\t\t\t">Gender&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">Age at diagnosis&#44; years</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Face&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Left hand&#44; right hand&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Thumb&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#58;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Index finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Middle finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#58;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Index finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#58;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ring finger&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#58;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Palm&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#58;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Under nail&#44; Skin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#58;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Size&#44; cm</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mean &#40;Range&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;79 &#40;0&#46;1&#8210;3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Symptom&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pain &#40;Cold intolerance&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Painless&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pathology&#44; n</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Solid glomus tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomangioma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomangiomyoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Initial diagnosis&#44; n &#40;&#37;&#41;</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Glomus tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38 &#40;63&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vascular tumor&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;13&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cystis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;10&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Swelling&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;5&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Pyogenic granuloma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibroma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;3&#46;3&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Foreign body&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#46;7&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Summary of clinicopathologic findings in 60 patients with glomus tumor&#46;</p>"
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      "titulo" => "References"
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        0 => array:2 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Glomus tumor of the duodenum&#58; a rare case report"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Sasaki"
                            1 => "Y&#46; Takami"
                            2 => "Y&#46; Wada"
                            3 => "T&#46; Ryu"
                            4 => "H&#46; Imamura"
                            5 => "H&#46; Ureshino"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s40792-020-01084-5"
                      "Revista" => array:5 [
                        "tituloSerie" => "Surg Case Rep"
                        "fecha" => "2020"
                        "volumen" => "6"
                        "paginaInicial" => "305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33270165"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
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            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunohistochemical demonstration of cyclooxygenase-2 in glomus tumors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Yanai"
                            1 => "T&#46; Tanaka"
                            2 => "T&#46; Ogawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2106/JBJS.L.00341"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Bone Joint Surg Am"
                        "fecha" => "2013"
                        "volumen" => "95"
                        "paginaInicial" => "725"
                        "paginaFinal" => "728"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23595071"
                            "web" => "Medline"
                          ]
                        ]
                      ]
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            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subungual glomus tumors&#58; an algorithmic approach"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;J&#46; Rohrich"
                            1 => "L&#46;M&#46; Hochstein"
                            2 => "R&#46;H&#46; Millwee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00000637-199409000-00011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Plast Surg"
                        "fecha" => "1994"
                        "volumen" => "33"
                        "paginaInicial" => "300"
                        "paginaFinal" => "304"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7985967"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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                ]
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              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunohistochemical demonstration of substance P-containing nerve fibres in glomus tumours"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Kishimoto"
                            1 => "H&#46; Nagatani"
                            2 => "A&#46; Miyashita"
                            3 => "K&#46; Kobayashi"
                          ]
                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.1985.tb02067.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1985"
                        "volumen" => "113"
                        "paginaInicial" => "213"
                        "paginaFinal" => "218"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2411282"
                            "web" => "Medline"
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              "identificador" => "bib0025"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Color Doppler ultrasound morphology of glomus tumors of the extremities"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Z&#46; Fan"
                            1 => "G&#46; Wu"
                            2 => "B&#46; Ji"
                            3 => "C&#46; Wang"
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Article information
ISSN: 03650596
Original language: English
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