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Daher M, Aouad D, Saade J, Wehbe J. Glomus tumor of the patellar tendon: a case report and review of the literature. J Med Case Rep 2025; 19:129. [PMID: 40114267 PMCID: PMC11924761 DOI: 10.1186/s13256-025-05166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/22/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND A rare finding, the glomus tumor is made up of cells that resemble modified smooth muscle cells. It usually arises in the deep dermis of the palms and the wrists. However, it can still appear in atypical places such as the knee presenting with atypical symptoms. CASE REPORT This case report is about a 43-year-old previously healthy Middle Eastern male with a glomus tumor of the distal portion of the patellar tendon presenting as continuous dull pain of the right knee for the previous 2 years. CONCLUSION Glomus tumor, a mostly benign lesion usually found in subungual area in the hand, can be found in the knee as well. It can be diagnosed with magnetic resonance imaging, appearing bright on T2-weighted images with diffuse enhancement following gadolinium injection and as a well-defined dark lesion on T1-weighted images. Histological examination remains the only confirmatory diagnosis, showing sheets and clusters of homogeneous glomus cells encircling arteries.
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Affiliation(s)
| | - Dany Aouad
- Saint Georges Hospital University Medical Center, Achrafieh, Lebanon
| | - Jamal Saade
- Saint Georges Hospital University Medical Center, Achrafieh, Lebanon
| | - Joseph Wehbe
- Saint Georges Hospital University Medical Center, Achrafieh, Lebanon
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Falcone MO, Asmar G, Chassat R. Subungual glomus tumor. HAND SURGERY & REHABILITATION 2024; 43S:101607. [PMID: 37866479 DOI: 10.1016/j.hansur.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
Subungual glomus tumors arise from the glomus body of the digits. They are rare and benign and often in a single location. Their diagnosis relies on the typical clinical triad of symptoms and on imaging findings, mainly magnetic resonance imaging with gadolinium injection. Subungual tumors treatment is complete resection, essential for cure. The different surgical techniques aim to: a painless digit with normal range of motion and sensitivity, without nail deformity after tumour resection, and to recurrence prevention. They vary according to tumor location. Classic surgical approaches are: the nail unit sparing ones (para-ungual, lateral subperiosteal, periungual), and the nail unit non-sparing ones (all transungual approaches with nail bed splitting). In this paper, we review the literature for the different approaches describing the advantages and drawbacks of each of them. We also describe the author's preferred subperiosteal "shark mouth" flap containing the nail plate and the nail bed as a single unit. It can be performed whether the tumor is located centrally, peripherally, or under the germinal matrix with very satisfactory outcomes.
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Affiliation(s)
- Marc-Olivier Falcone
- Clinique Jouvenet, Capio - Ramsay Santé, 6 Square Jouvenet, 75016 Paris, France; Hôpital Privé Paul d'Egine, Capio - Ramsay Santé, 4 Avenue Marx Dormoy, 94500 Champigny sur Marne, France.
| | - Ghada Asmar
- Hôpital Privé Paul d'Egine, Capio - Ramsay Santé, 4 Avenue Marx Dormoy, 94500 Champigny sur Marne, France
| | - Romain Chassat
- Hôpital Privé de l'Ouest Parisien, Capio - Ramsay Santé, 14 Rue Castiglione Del Lago, 78190 Trappes, France
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Niu B, Zheng C, Hu F. Strontium 90 combined with surgery for a patient with giant subungual glomus tumor. Asian J Surg 2023; 46:4549-4551. [PMID: 37244832 DOI: 10.1016/j.asjsur.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 04/28/2023] [Accepted: 05/02/2023] [Indexed: 05/29/2023] Open
Affiliation(s)
- Bin Niu
- Department of Dermatology, Huangshi Central Hospital, Affliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, China
| | - Chen Zheng
- Department of Dermatology, Huangshi Central Hospital, Affliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Hubei Key Laboratory of Kidney Disease Pathogenesis and Intervention, China.
| | - Fei Hu
- School of Electrical Engineering and Automation, Hubei Normal University, Huangshi, Hubei, China
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Hwang JK, Lipner SR. Blue Nail Discoloration: Literature Review and Diagnostic Algorithms. Am J Clin Dermatol 2023; 24:419-441. [PMID: 36971947 DOI: 10.1007/s40257-023-00768-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 03/29/2023]
Abstract
Blue nail discoloration is a distinctive clinical presentation, and diagnosis is challenging given the broad differential diagnosis. A comprehensive review of the literature describing blue discoloration of one or multiple nails was performed using the PubMed, Embase, Scopus, and Web of Science databases. A total of 245 publications were included and grouped based on involvement of a single nail (monodactylic) or multiple nails (polydactylic). Monodactylic blue discoloration was associated with tumors or benign nevi, most commonly glomus tumors, followed by blue nevi and less commonly melanomas. Polydactylic blue discoloration was frequently associated with medications (such as minocycline, zidovudine, and hydroxyurea), toxic and exogenous exposures (such as silver), and other medical conditions (such as HIV/AIDS and systemic lupus erythematous). Patients presenting with blue nail discoloration warrant a thorough history, physical examination, and workup to rule out malignancy, systemic disease, or toxic exposure. We present diagnostic algorithms for monodactylic and polydactylic blue nail discoloration to guide workup and treatment plans.
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Wang HY, Duan P, Chen H, Pan ZY. Unusual glomus tumor of the lower leg: A case report. World J Clin Cases 2022; 10:3485-3489. [PMID: 35611196 PMCID: PMC9048558 DOI: 10.12998/wjcc.v10.i11.3485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 11/07/2021] [Accepted: 02/27/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Glomus tumors are rare neoplasms, usually found on the fingers or toes. Glomus tumours that occur in the lower leg are even rarer and is likely to be misdiagnosed or underdiagnosed. This article will document the diagnosis, treatment, and follow-up of a rare glomus tumor of the lower leg, which had been misdiagnosed for up to 15 years.
CASE SUMMARY The patient was a A 36-year-old woman who had suffered from localized pain in her left lower leg for 15 years. After a complete physical examination, a glomus tumor on her lower leg was considered and removed surgically. The specimen was pathologically diagnosed as a glomus tumor. There was no relapse at a 4-year follow-up.
CONCLUSION Correct diagnosis and complete removal of the glomus tumor is important.
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Affiliation(s)
- Han-Yu Wang
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei Province, China
| | - Ping Duan
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei Province, China
| | - Hui Chen
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei Province, China
| | - Zhen-Yu Pan
- Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430000, Hubei Province, China
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Liu B, Chen W, Lu L. [A distal curved incision approach of lunula for treatment of subungual glomus tumor in nail root]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2020; 34:1294-1297. [PMID: 33063496 DOI: 10.7507/1002-1892.202003035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Obejective To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root. Methods Between March 2017 and October 2019, 16 patients (16 fingers) with subungual glomus tumor in nail root were treated. There were 2 males and 14 females with an average age of 35.3 years (range, 21-67 years). The disease duration ranged from 5 months to 17 years, with a median duration of 15 months. There were 6 cases of thumb, 3 cases of index finger, 2 cases of middle finger, 4 cases of ring finger, and 1 case of little finger. All of them showed typical "triad syndromes", and the cold sensitivity test and Love test were positive before operation. Each patient removed the nail, the tumor was exposed under the nail bed via the distal curved incision approach of lunula. After the tumor was removed completely, the nail bed was reducted in situ without suturing. The self-made nail template was pressurized and fixed on the surface of the nail bed with suture. The conditions of nail bed healing, pain, and growth of nail were observed after operation. Results All wounds of the nail bed with laceration healed by first intention. Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients. All cases were followed up 3-26 months with an average of 15 months. The pain symptom disappeared and no obvious pain occurred during dressing change in all cases; and the cold sensitivity test and Love test were negative. The nails recovered smoothly with satisfactory appearance, and no obvious complications such as longitudinal ridge deformities or recurrences was observed. Conclusion The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method, which can easily operated, resect the tumor completely, protect the nail bed effectively, and also has a significant effect on preventing postoperative nail deformity.
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Affiliation(s)
- Bin Liu
- Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei Anhui, 230001, P.R.China
| | - Weijian Chen
- Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei Anhui, 230001, P.R.China
| | - Liang Lu
- Department of Orthopedics, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei Anhui, 230001, P.R.China
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Christian BP. Extradigital glomus tumor of the anterior knee. CASE REPORTS IN PLASTIC SURGERY AND HAND SURGERY 2020; 7:105-107. [PMID: 32939365 PMCID: PMC7470091 DOI: 10.1080/23320885.2020.1810579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The benign glomus tumor is an uncommon cause of crippling pain most commonly associated with the fingers. This sheep in wolf’s clothing is identified by careful examination, confirmed by MRI, and often resolved with a simple procedure. Here we present a patient with chronic knee pain of 21 years duration.
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8
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Asmar G, Mati T, Pop IA, Falcone MO. The 'shark mouth' flap approach for digital glomus tumours in 24 patients: technique and clinical outcomes. J Hand Surg Eur Vol 2020; 45:153-159. [PMID: 31414608 DOI: 10.1177/1753193419867049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
This retrospective, single-centre study was carried out on patients with digital subungual glomus tumours. We describe a subperiosteal approach with a 'shark mouth' flap containing the nail plate and nail bed as a single unit, providing ideal exposure and easy access to the tumour. It combines the advantages of the transungual and lateral approaches, whether the subungual tumours are located centrally, peripherally or under the germinal matrix. The 'shark mouth' flap approach was used by the same surgeon in 24 patients with solitary glomus tumours of the fingers. Clinical outcomes at the early postoperative phase and at the last follow-up were satisfactory. Pain relief and wound healing were quickly achieved. No complications, such as fingertip numbness or nail deformities, were observed, and there was only one recurrence. This approach is reliable, nail-sparing and less time-consuming than other techniques. Level of evidence: IV.
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Affiliation(s)
- Ghada Asmar
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France
| | - Tahar Mati
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France
| | - Ioana Anastasia Pop
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France
| | - Marc-Olivier Falcone
- Ramsay Générale de Santé - Capio, Hôpital Privé Paul d'Egine, Champigny-sur-Marne, France.,Clinique Internationale du Parc Monceau, Paris, France
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Glomangioma of Uncertain Malignant Potential: A Case Report. Case Rep Orthop 2020; 2020:4237076. [PMID: 32089928 PMCID: PMC6975219 DOI: 10.1155/2020/4237076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/13/2019] [Indexed: 12/20/2022] Open
Abstract
Glomus tumors are rare benign tumors which commonly affect the hand but are seldom seen extradigitally. Less commonly seen is the glomangioma, a variant of benign glomus tumor, and even rarer is the glomangiosarcoma, a malignant variant. Determining malignancy can be difficult and an intermediate diagnosis, glomus tumor of uncertain malignant potential, has been proposed. We present a case of a 56-year-old male with a recurrent forearm mass diagnosed as a glomangioma of uncertain malignant potential. Although the characteristics and behavior of malignant cases are still incompletely understood, it is important that a high index of suspicion be maintained when approaching these tumors, especially when large or recurrent. Glomangiomas should be included in the differential diagnosis when evaluating soft tissue masses in the forearm and should be evaluated for malignant features.
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Kurohara K, Michi Y, Yukimori A, Yamaguchi S. The glomus tumor resorbed bone and teeth in the mandible: a case report. Head Face Med 2018; 14:18. [PMID: 30253798 PMCID: PMC6156871 DOI: 10.1186/s13005-018-0175-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 09/18/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A glomus tumor is a rare neoplasm usually found in the dermis or subcutaneous tissue of the extremities. It is rare for the glomus tumor to occur on the head and face. Only 26 glomus tumors of the oral region and affected bone have been reported in the English-language literature (Table 1). We report a case of a glomus tumor at the mandible. As a new point, the glomus tumor resorbed a bone and teeth roots when the tumor progressed into the mandible. CASE PRESENTATION The patient was a 44-year-old Japanese man who complained swelling of the right mandible. Radiographic examination showed a multilocular radiolucency area in the left mandible. Radiographic findings on our case resembled those of a common benign tumor. The lesion occupied to the premolar and molar area and revealed that the tumor resorbed the roots of the teeth. The lesion was removed surgically with the buccal cortical bone and buccal mucosa in contact with the mass of the tumor. The mass fully excised intraorally under general anesthesia, and the inferior alveolar nerve in contact with the mass was preserved. The specimen was pathologically diagnosed as a glomus tumor. Immunohistochemical staining was positive for vimentin, muscle-specific actin/HHF35, and calponin. A hairline-shaped area of positive staining for type IV collagen surrounding the tumor cells was also observed. In contrast, staining for alpha-SMA, cytokeratin (AE1/AE3), cytokeratin (CAM5.2), CK19, CD31, CD34, CD68, p63, S-100, Factor VIII, and desmin was all negative. The Ki-67 labeling index was almost 1%. A recurrent tumor was again detected in the site below the primary tumor at an 8-year follow-up, and it was surgically removed. The patient has had no symptoms of recurrence in 2 years after the second operation. CONCLUSION The glomus tumor resorbed a bone and teeth roots when the tumor progressed into the mandible. The immunohistochemical features of the tumor were consistent with those described in previous reports. It is important to completely remove the Glomus tumor.
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Affiliation(s)
- Kazuto Kurohara
- Department of Oral and Maxillofacial Surgery, Graduate School, Mie University, 174, Edobashi 2-chome, Tsu-shi, Mie 514-8507 Japan
- Department of Maxillofacial Surgery, Division of Maxillofacial and Neck Reconstruction, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuyuki Michi
- Department of Maxillofacial Surgery, Division of Maxillofacial and Neck Reconstruction, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
| | - Akane Yukimori
- Department of Oral Pathology, Division of Oral Health Sciences, Graduate school of Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoshi Yamaguchi
- Department of Maxillofacial Surgery, Division of Maxillofacial and Neck Reconstruction, Graduate School of Tokyo Medical and Dental University, Tokyo, Japan
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Li L, Xu QX, Zhang XY, Han CH. Unusual location of the glomus tumour in the liver: A case report and literature review. Medicine (Baltimore) 2018; 97:e11294. [PMID: 29953012 PMCID: PMC6039582 DOI: 10.1097/md.0000000000011294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 05/23/2018] [Indexed: 01/17/2023] Open
Abstract
RATIONALE Liver glomus tumor is very rare, and only 6 cases have been reported. Herein, we report another case of liver glomus tumor and the clinicopathological features are summarized. PATIENT CONCERNS An 18-year-old male patient was admitted due to hypertension and arrhythmia for 4 days. DIAGNOSES Abdominal enhanced CT revealed a 6.0-cm solid and cystic mass in the left liver lobe. The mass was collected by hepatic lobectomy. Microscopically, the tumor cells were round or oval, and had no malignant features and no evident atypia. Immumohistochemically, tumor cells were positive for positive for SMA and vimentin, but partially positive for syn, CD34 and desmin. He was pathologically diagnosed with liver glomus tumor. INTERVENTIONS The patient underwent a left hepatic lobectomy. OUTCOMES After surgery, this patient was followed up for 6 months, and metastasis/recurrence was not observed. LESSONS Primary liver glomus tumor has no specific clinical manifestations, and imaging examinations have limitations for its diagnosis. Immunostaining for SMA and vimentin is necessary to prove the diagnosis. Complete resection is strongly advised and it has a favorable prognosis.
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Tumores glómicos en el miembro superior. Revisión de la literatura e informe de 14 casos. REVISTA IBEROAMERICANA DE CIRUGÍA DE LA MANO 2017. [DOI: 10.1016/j.ricma.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Objetivo: Revisar los resultados del tratamiento quirúrgico de los tumores glómicos del miembro superior tratados en nuestro servicio de cirugía de la mano en los últimos 15 años y comparar con la bibliografía especializada los datos de una serie de 14 tumores operados.Material y método: Se trataron 14 tumores glómicos en 14 pacientes: 7 hombres y 7 mujeres. La media de edad fue de 50,7 años (rango 31-70).En todos los pacientes se anotó la zona de presentación del tumor, su aspecto macroscópico con registro fotográfico, la técnica quirúrgica y el resultado final, funcional y estético.Resultados: En todos los pacientes se dieron presentaciones únicas y todos se curaron completamente con el tratamiento quirúrgico, pero en 2 hubo recidivas y uno de ellos debió operarse hasta 5 veces para erradicar el tumor completamente.Conclusión: El tumor glómico, por su infrecuencia, es poco conocido fuera del ámbito de la cirugía de la mano y de la dermatología, de ahí la demora en el diagnóstico que padecen buena parte de los pacientes. Los de presentación extradigital no suelen sospecharse y su diagnóstico lo aporta el estudio anatomopatológico.El tratamiento quirúrgico, consistente en la exéresis de la masa tumoral y el legrado de la cavidad ósea si la hay, es resolutivo en la mayor parte de los casos, si bien la tasa de recidivas es muy elevada, probablemente por haberse realizado una escisión incompleta.La complicación más frecuente es de tipo estético, por deformidades de la uña en los tumores de presentación subungueal.
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El Hyaoui H, Messoudi A, Rafai M, Garch A. Unusual localization of glomus tumor of the knee. Joint Bone Spine 2016; 83:213-5. [DOI: 10.1016/j.jbspin.2015.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2015] [Indexed: 10/22/2022]
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Jalan D, Elhence A, Rathore DS, Maley DK. A recurred subungual glomus tumour of the thumb. BMJ Case Rep 2016; 2016:bcr-2015-212963. [PMID: 26729827 DOI: 10.1136/bcr-2015-212963] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Glomus tumours are rare benign neoplasms arising from the glomus body, accounting for 1-5% of all soft-tissue tumours of the hand. The diagnosis of glomus tumour is frequently delayed, varying from 3 to 15 years. We present a case of a recurred glomus tumour of the thumb where symptoms persisted for a period of 6 years after an attempted surgical excision. The patient presented with classical symptoms of localised tenderness, cold sensitivity and excruciating pain on touch. Findings on radiograph, ultrasonography and contrast-enhanced MRI further supported the diagnosis. Complete surgical excision, the only recommended treatment, resulted in complete symptomatic relief to the patient. This case report highlights the importance of meticulous complete excision and clinical awareness of the disease among primary care physicians.
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Affiliation(s)
- Divesh Jalan
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Abhay Elhence
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Devendra Singh Rathore
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| | - Deepak Kumar Maley
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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15
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Gonçalves R, Lopes A, Júlio C, Durão C, de Mello RA. Knee glomangioma: a rare location for a glomus tumor. Rare Tumors 2014; 6:5588. [PMID: 25568752 PMCID: PMC4274446 DOI: 10.4081/rt.2014.5588] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/07/2014] [Accepted: 09/09/2014] [Indexed: 11/22/2022] Open
Abstract
Glomus tumor is a rare, benign neoplasm rising from the glomus apparatus of the skin. It occurs most frequently on fingers and toes and accounts for 1.6% of all soft tissue tumors. Clinical diagnosis may prove difficult if the tumor occurs on an extra digital location. We report a case of a vascular-type glomus tumor (glomangioma) found in an atypical location, namely the lateral aspect of the knee joint.
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Affiliation(s)
- Ricardo Gonçalves
- Department of Orthopedic Surgery, Hospital Vila Franca de Xira, , Porto
| | - Ana Lopes
- Department of Orthopedic Surgery, Hospital Vila Franca de Xira, , Porto
| | - Clara Júlio
- Department of Orthopedic Surgery, Hospital Vila Franca de Xira, , Porto
| | - Carlos Durão
- Department of Orthopedic Surgery, Hospital Vila Franca de Xira, , Porto
| | - Ramon Andrade de Mello
- Department of Medical Oncology, Instituto Português de Oncologia Francisco Gentil, Porto
- Department of Biomedical Science and Medicine, Medical School, University of Algarve, Faro, Portugal
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16
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Chiang YP, Hsu CY, Lien WC, Chang YJ. Ultrasonographic appearance of subungual glomus tumors. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:336-340. [PMID: 24526654 DOI: 10.1002/jcu.22138] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 09/18/2013] [Accepted: 01/14/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND To describe the sonographic (US) features of pathologically confirmed subungual glomus tumors. METHODS We retrospectively analyzed cases of pathologically confirmed subungual glomus tumors in patients presenting between December 1, 2008 and October 31, 2012, selected from cases in the musculoskeletal US database of a single institution. RESULTS Data on 14 patients with pathologically proven glomus tumors were retrieved from the US database. The tumor size ranged from 1.9 to 10.0 mm (mean ± SD, 5.3 ± 2.3 mm). Well-circumscribed tumors with clear margins were identified on US in 12 cases (86%): 11 (92%) tumors were hypoechoic and 1 (8%) was isoechoic. On power or color Doppler US, 11 of these 12 tumors (92%) appeared hypervascular. Two of the 14 tumors did not show a clearly circumscribed mass on gray-scale US, and bony erosion was the only US finding in one of the two cases. Seven of the 14 patients (50%) showed focal bony erosion in the underlying phalangeal bone. CONCLUSIONS A hypervascular mass in the nail bed was the most common US finding associated with subungual glomus tumors. We found that focal hypervascularity supports the diagnosis, and bony erosion is commonly associated with digital glomus tumors.
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Affiliation(s)
- Yi-Pin Chiang
- Department of Rehabilitation Medicine, Mackay Memorial Hospital, Taipei, Taiwan
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Seo JH, Lee HS, Kim SW, Jeong JJ, Choi YR. Subungual glomus cell proliferation in the toe: a case report. J Foot Ankle Surg 2014; 53:628-30. [PMID: 24751589 DOI: 10.1053/j.jfas.2014.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Indexed: 02/03/2023]
Abstract
Glomus tumors are rare benign neoplasms. They typically present with a triad of severe pain, point tenderness, and cold sensitivity. Most glomus tumors will form well-circumscribed nodules, and excisional biopsy of masses detected by ultrasonography or magnetic resonance imaging of the lesion can relieve the symptoms. We describe a 30-year-old female patient with nontumorous glomus cell proliferation with clinical symptoms similar to those of glomus tumors. The lesion was treated by exploration and excision, with a satisfactory clinical outcome.
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Affiliation(s)
- Jeong Ho Seo
- Clinical Fellow, Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Ho Seong Lee
- Professor, Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Sang Woo Kim
- Assistant Professor, Department of Orthopaedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea
| | - Jae Jung Jeong
- Assistant Professor, Department of Orthopaedic Surgery, Daejeon St Mary's Hospital, Catholic University of Korea College of Medicine, Daejeon, South Korea
| | - Young Rak Choi
- Assistant Professor, Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam-Si, Gyeonggi-do, South Korea
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Where is the Lesion? Glomus Tumours of the Hand. Arch Plast Surg 2013; 40:492-5. [PMID: 24086799 PMCID: PMC3785579 DOI: 10.5999/aps.2013.40.5.492] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 05/06/2013] [Accepted: 05/07/2013] [Indexed: 12/28/2022] Open
Abstract
Glomus tumours are vascular hamartomas that are commonly found in the hand, particularly the subungual region. They appear as solitary or multiple tumours, and often present as a bluish discoloration of the nail plate. Different diagnostic tests are outlined, as well as imaging studies such as magnetic resonance imaging and ultrasound. Misdiagnosis and delayed diagnosis of these tumours are common, while a familial tendency is a potential risk factor but not yet proven. Complete surgical excision often results in complete symptomatic relief, while recurrences are largely due to incomplete excision or the growth of a new glomus tumour. This article aims to review the key aspects of glomus tumours and provide a diagnostic algorithm so that the lesion can be recognized and treated earlier.
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Robert G, Sawaya E, Pelissier P. [Glomus tumor of the dorsal aspect of the wrist: a case report]. ACTA ACUST UNITED AC 2012; 31:214-6. [PMID: 22796343 DOI: 10.1016/j.main.2012.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 03/12/2012] [Accepted: 04/16/2012] [Indexed: 11/29/2022]
Abstract
Extra-digital glomus tumors are extremely rare and difficult to diagnose. The authors report a case of glomus tumor of the dorsal aspect of the wrist, discovered incidentally after surgical resection in a 71-year-old patient.
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Affiliation(s)
- G Robert
- Service de chirurgie plastique reconstructrice et esthétique et chirurgie de la main, centre François-Xavier Michelet, CHU de Bordeaux, place Amélie-Raba-Léon, Bordeaux, France.
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20
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Abbassi A, Amrani A, Dendane MA, El Alami Z, El Madhi T, Gourinda H. [Glomus tumor of the finger pulp: an unusual pediatric case]. ACTA ACUST UNITED AC 2012; 37:219-21. [PMID: 22727476 DOI: 10.1016/j.jmv.2012.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 05/07/2012] [Indexed: 10/28/2022]
Abstract
Glomus tumor is a rare benign tumor. Diagnosis is often delayed because of the absence of specific symptoms and confirmation can only be made by histological study. Treatment is always surgical. We report a clinical case of glomus tumor of the thumb pulp in a 6-year-old girl, and we discuss clinical, radiological and histological aspects of this tumor.
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Affiliation(s)
- A Abbassi
- Service d'orthopédie pédiatrique, hôpital d'enfants, boulevard Ibn-Rochd, Souissi, 10100 Rabat, Maroc. asma
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Abstract
UNLABELLED Glomus tumors, especially multiple ones, are uncommon skin and soft tissue neoplasms occasionally seen in various internal organs. Involvement of the external genital organs including penis is extremely rare, and until now, scarce cases have been reported in the available literature. MATERIALS AND METHODS A routine histologic and immunohistochemical staining for pan-muscle actin, α-smooth muscle actin, desmin, CD31, and CD34 was applied for diagnosis of the lesions. RESULTS Three soft, bluish, and tender tumors localized on the ventral aspect of the glans penis in a 9-year-old boy were found. Furthermore, 3 other lesions situated on the fingers and the plantar surface of the foot were later sequentially noted. Local excisions of all tumors were performed, and glomangiomas were diagnosed based on typical microscopic features as well as immunohistochemical findings, that is, positive immunoexpression for actin but negative for desmin, CD31, and CD34. No recurrence was noted during the 5-year follow-up. CONCLUSIONS On the basis of our experience, conservative surgical procedure is sufficient for penile glomus tumors. However, each patient should be carefully examined for possible extragenital lesions.
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Double glomus tumors originating in the submandibular and parotid regions. Clin Exp Otorhinolaryngol 2011; 4:49-51. [PMID: 21461064 PMCID: PMC3062228 DOI: 10.3342/ceo.2011.4.1.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Accepted: 10/01/2010] [Indexed: 01/06/2023] Open
Abstract
Glomus tumors are rare neoplasms that originate from the glomus bodies, an arteriovenous anastomosis with a specialized vascular structure. The most common site for these tumors is the subungal region of the fingers. Occasionally, glomus tumors are found in the middle ear, trachea, nasal cavities, stomach, and lungs. The occurrence in the parotid regions is very rare. While multiple glomus tumors in the whole body are thought to represent only 10% of all cases, instances of multiple tumors in the neck have not yet been reported in the literature. We report a case of double glomus tumors in the submandibular and parotid regions.
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Abstract
AIM AND BACKGROUND Glomus tumors are hamartomas that account for 1% to 5% of all soft tissue tumors of the hand. These tumors are usually benign. However, malignant degeneration can sometimes occur. They are usually characterized clinically by paroxysmal pain. Herein, we present our experience with 8 patients diagnosed with glomus tumors treated within the past 10 years. MATERIALS AND METHODS Eight patients who were diagnosed with glomus tumor of the hand were treated. Excruciating pain upon palpating the tumor was present in all the patients. Imaging studies such as magnetic resonance imaging were obtained but were only marginally helpful in locating and defining the surface topography for tumor resection. Meticulous dissection in a bloodless field and use of an operating microscope from the start of the operation were used for complete removal. RESULTS Complete excision of the tumor with free margins was confirmed in all 8 cases. However, 1 of the patients had recurrence of the tumor, which presented 4 weeks postoperatively. No other recurrence was observed during the follow-up period (1 to 10 y). The postoperative course in all patients was uneventful except for deformed fingernail formation in 3 of the patients. CONCLUSIONS Glomus tumor is a rare disease; we encountered only 0.26% cases in our patients (3014 patients referring for hand surgery) during a 10-year period. Imaging studies are not very helpful. Preoperative marking of the maximum point of pain helps the surgeon somewhat to locate the tumor clinically. We believe that a bloodless operation field and magnification are essential prerequisites for successful surgery. We also note that pain alleviation and no pain recurrence 2 months after surgery clinically signify a cure. The possible development of permanent nail deformity should be anticipated and must be discussed with the patient preoperatively.
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Romanowski L, Czarnecki P, Brȩborowicz M. Benign and Malignant Hand Tumors. Plast Reconstr Surg 2010. [DOI: 10.1007/978-1-84882-513-0_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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25
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Intravenous pyogenic granuloma of the finger. Jpn J Radiol 2009; 27:328-32. [DOI: 10.1007/s11604-009-0346-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Accepted: 06/29/2009] [Indexed: 11/25/2022]
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Kampshoff JL, Cogbill TH. Unusual skin tumors: Merkel cell carcinoma, eccrine carcinoma, glomus tumors, and dermatofibrosarcoma protuberans. Surg Clin North Am 2009; 89:727-38. [PMID: 19465208 DOI: 10.1016/j.suc.2009.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This article discusses the epidemiology, etiology, presentation, pathology, evaluation and staging, and treatment of unusual skin tumors, such as Merkel cell carcinoma, eccrine carcinoma, glomus tumors, and dermatofibrosarcoma protuberans.
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Affiliation(s)
- Jesse L Kampshoff
- Department of Medical Education, Gundersen Lutheran Medical Foundation, 1900 South Avenue, C03-006A, La Crosse, WI 54601, USA
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Espinosa-Gutierrez A, Izaguirre A, Baena-Ocampo L, Feynoso-Campo R, Pineda C. Images in Rheumatology. Glomus tumor. J Rheumatol 2009; 36:1343-4. [PMID: 19509091 DOI: 10.3899/jrheum.081026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Frikh R, Alioua Z, Harket A, Ghfir M, Sedrati O. Tumeurs glomiques : étude anatomoclinique de 14 cas avec revue de littérature. ANN CHIR PLAST ESTH 2009; 54:51-6. [DOI: 10.1016/j.anplas.2008.05.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2008] [Accepted: 05/15/2008] [Indexed: 11/29/2022]
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Daghir A, Anand P, Gabra H, Elliot D. Drug-induced exacerbation of glomus tumour pain. JOURNAL OF HAND SURGERY (EDINBURGH, SCOTLAND) 2006; 31:692. [PMID: 16766103 DOI: 10.1016/j.jhsb.2006.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2006] [Revised: 04/18/2006] [Accepted: 04/21/2006] [Indexed: 05/10/2023]
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Abstract
Glomus tumors are rare vascular tumors that are found most commonly in the hand. Although the tumors are benign, they can cause intense focal pain. Patients often go undiagnosed or misdiagnosed for many years because the tumors are small, usually not palpable, and have varying presentations. A combination of magnetic resonance imaging and clinical examination is used to support the diagnosis. Surgical excision normally provides complete pain relief. An awareness of the diagnosis is critical to preventing an unnecessary delay in treatment.
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Affiliation(s)
- Erin M McDermott
- Department of Orthopaedics, Brown Medical School, Rhode Island Hospital, Providence, 02905, USA
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