Glomangioma in the hand: diagnosis, treatment, and challenges.

INTRODUCTION: In this paper, we have analysed all hand glomangioma cases referred to our clinic in the context of symptoms, time to diagnosis, and the role of surgical resection of the lesion. MATERIAL AND METHODS: We have collected the following data: the presence of risk factors, manifestation, time to diagnosis, the treatment applied, and follow-up of patients. RESULTS: We have collected medical records from six patients, three males and three females. The median age was 45 (IQR: 29.5-65.75). The main symptom in all patients was severe pain and tenderness. The first-choice physician(s) were: general practitioners, general surgeons, and neurologists. The median time to diagnosis was 7 (IQR: 5-10) years. The main complaint of our patients was severe pain - 9 (IQR: 9-10) on the VAS scale, which was significantly alleviated after surgical treatment - 0 (IQR: 0-0; p = 0.043). CONCLUSIONS: Extremely long times to final diagnosis, and excellent outcomes of surgical treatment, highlight the necessity of raising awareness of glomangiomas among clinicians.

Multiple intraneural glomus tumors in different digital nerve fascicles.

BACKGROUND: Glomus tumors in the digital nerve are extremely rare. Multiple intraneural glomus tumors in different digital nerve fascicles have not been previously reported. CASE PRESENTATION: We report the case of a 54-year-old male with a 1-year history of progressive numbness of the middle finger with point tenderness at the level of the middle phalanx. Surgical incision revealed the presence of two glomus tumors within different fascicles of the ulnar digital nerve of the middle finger. One tumor was excised along with surrounding fascicle, the other was removed leaving the fascicle intact. Subsequently, the patient regained function of the finger and no tumors have recurred. CONCLUSIONS: Patients and physicians should be aware of the properties of intraneural glomus tumors so that early diagnosis and treatment can be sought.

[Glomuvenous malformations]. / Glomuvenöse Malformationen.

SYMPTOMS: A patient presented suffering from neural pain in the medial foot for a period of over 20 years. DIAGNOSIS: Diagnostic showed a widely spread soft-tissue tumor consisting of confluent glomuvenous malformations that was responsible for the immense pain syndrome.The solitary or multiform-appearing knots are not compressible and manifest as the characteristic syndromes of regional pain, sensitivity to coldness, or local pressure pain. Alternatively, the patient could also be completely symptom-free. TREATMENT: Because of the dimension of the tumor and the degree of suffering, a radical resection with simultaneous microsurgical reconstruction was carried out. Twelve weeks postoperatively, healing of the flap stabilized, the foot is fully weight-bearing, and the patient is pain-free.

Nd:YAG laser offers promising treatment option for familial glomuvenous malformation.

Although an uncommon entity, familial glomangiomatosis is often a source of significant discomfort to affected patients and impacts quality of life. Patients develop numerous painful vascular lesions, beginning in childhood. Because management strategies for this entity are sparsely reported in the literature, additional study is needed to establish best practice. We report positive results with the use of Nd:YAG laser in treating symptomatic lesions of familial glomuvenous malformation.

Glomus tumor as a cause of coccydynia.

Glomus coccygeum is a network of glomus bodies located around pericoccygeal soft tissue. The question of whether it accounts for coccydynia has been debated. We report on a patient whose preoperative symptoms suggested the impression of glomus tumor of the coccyx; pain was relieved after removal of the lesion without coccygectomy. A 57-year-old woman was referred to us with a history of a pain in the coccygeal area lasting longer than 3 years. The patient complained of sharp pain whenever pressure was applied to the coccyx. Pain was aggravated by exposure to cold. MRI revealed a coccygeal lesion measuring 2 cm with a well-circumscribed margin. The lesion was excised without removal of any portion of the coccyx. The pathology report confirmed a glomus tumor, which was an identical finding to the conventional one of the subungual region. Ten months after surgery, she had no pain on the coccygeal region and no difficulty with sitting on a chair and in performing activities of daily living. Findings reported here suggest that although most glomus bodies are normal anatomical variants, development of a glomus tumor could occur in the coccygeal region and could be a cause of coccydynia.

Glomus tumour of the male urethra: an unusual diagnostic.

A 56-year-old man was referred to a reconstructive urologist for evaluation of a tender nodule in the penoscrotal area. Penile Doppler ultrasound showed a non-compressible mass with internal vascularity within the corpora spongiosum, and MRI identified an enhancing, solid mass arising from the ventral aspect of the urethra. Surgical resection warranted partial excision and reconstruction of the urethra, which was achieved by a dorsal onlay buccal mucosal graft urethroplasty through a perineal incision with penile invagination. The histopathology report concluded to an invasive, high-grade urothelial carcinoma, for which an aggressive oncological approach was considered. However, discussion with the pathology team led to the identification of a glomus tumour for which the patient did not need additional procedures. Urethral glomus tumours are extremely rare and should be included in the differential diagnosis of urethral masses. This case exemplifies the importance of teamwork in the management of uncommon cases.

Glomus tumor in the second toe: a clinical insight.

UNLABELLED: Glomus tumors are rare benign tumors commonly occurring in the digits of the hand. Surprisingly, considering the fingertips are of a similar make-up to the toes, there have been few reports of glomus tumor in the toes. The present case highlights a glomus tumor observed in the right second toe of a 56-year-old Indian female who presented with the classical triad of spontaneous pain, cold hypersensitivity, and pressure tenderness. There was a delay in diagnosis for approximately 18 years by various general practitioners who were not aware of the rare presentation of the glomus tumor. The tumor, which measured 5 x 3 mm, was excised from the nail bed of the toe. Histopathological inspection confirmed the diagnosis of glomus tumor. We believe that reporting this rare case may make clinicians more aware of this unusual diagnosis. LEVEL OF CLINICAL EVIDENCE: 4.

Painful tumors in a patient with neurofibromatosis type 1: a case report.

BACKGROUND: Herein, we report an unusual case of multifocal glomus tumors in the same hand in a patient suffering from neurofibromatosis type 1. CASE PRESENTATION: The patient was a 37-year-old Moroccan woman, suffering from neurofibromatosis type 1, with intense pain in the fingers, successfully treated with the excision of the tumors. Histology of the lesions confirmed the diagnosis of glomus tumor. CONCLUSION: We present this case to support the association between glomus tumors and neurofibromatosis type 1. Thus, we strongly recommend that one should suspect a glomus tumor in patients with neurofibromatosis type 1 if such patients have symptoms from finger pulp or nails.

Neurotologic surgery for glomus tumors.

This article reviews the important aspects of glomus tumor management. The biology and histology of these tumors are unique and have an impact on treatment strategies. Nonsurgical options, such as radiation therapy, are discussed. Surgical resection can be performed safely only after appropriate diagnostic testing is completed. Imaging and other diagnostic testing are explored. The various resection and reconstructive strategies are discussed.

Tumor glômico em região hipotenar: relato de caso / Glomic tumor in hypotenar region: case report / Tumor glómico en región hipotenar: reporte de caso

Introdução: O tumor glômico é um hamartoma benigno, geralmente único, que se desenvolve a partir de uma estrutura neuromioarterial, o glomo. É uma doença incomum na prática dermatológica, muito frequente nas polpas digitais. Com relação à epidemiologia, corresponde a cerca de 1 a 5% dos tumores de mão e 65% dos casos estão localizados embaixo das unhas. Mostra-se mais prevalente em mulheres e mais frequente na terceira e quinta décadas de vida. Foi evidenciada uma escassez de estudos sobre tumor glômico em região palmar, falta de informações nacionais e necessidade de destacar a importância clínica desse tema. Objetivo: Relatar o caso de uma paciente com tumor glômico e enfatizar as características clínicas e o tratamento recomendado. Método: O caso é de uma paciente sexo feminino, negra, 61 anos apresentando dor intensa e localizada na lesão em região hipotenar da mão esquerda há dois anos. Caracteriza a dor como perene, nega irradiação, melhora ao usar compressa fria e piora ao usar compressa quente. Fez uso de analgésicos e anti-inflamatórios, não obtendo sucesso na melhora clínica. A dor se tornou de caráter intermitente e houve uma intolerância gástrica à medicação utilizada. Resultados: A melhora do quadro se deu após recorrer ao dermatologista, o qual realizou uma pequena cirurgia de retirada da lesão, apontando o diagnóstico de tumor. Conclusão: Diferentemente desse relato, em que a lesão é palmar, a maioria dos casos desse tumor benigno possuem lesões subungueais e nos dedos.(AU)

Introduction: Glomus tumor is a benign hamartoma, usually single, that develops from a neuromyoarterial structure, the glomus. It is an uncommon disease in dermatological practice, very common in digital pulps. Regarding epidemiology, it corresponds to about 1 to 5% of hand tumors and 65% of cases are located under the nails. It is more prevalent in women and more frequent in the third and fifth decades of life. A lack of studies on glomus tumors in the palmar region, lack of national information and the need to highlight the clinical importance of this topic was evidenced. Objective: Aimed to report the case of a patient with a glomus tumor and emphasize the clinical features and recommended treatment. Method: The case is a female patient, black, 61 years old with severe pain located in the lesion in the hypothenar region of the left hand for two years. Characterizes pain as perennial, denies irradiation, improves when using a cold compress and worsens when using a hot compress. He used analgesics and antiinflammatory drugs, with no success in clinical improvement. The pain became intermittent and there was gastric intolerance to the medication used. The condition improved after resorting to a dermatologist, who performed a minor surgery to remove the lesion, indicating the diagnosis of glomus tumor. Conclusion: Unlike this report, in which the lesion is palmar, most cases of this benign tumor have subungual lesions and lesions on the fingers.(AU)

Introducción: El tumor glómico es un hamartoma benigno, generalmente único, que se desarrolla a partir de una estructura neuromioarterial, el glomus. Es una enfermedad poco común en la práctica dermatológica, muy común en las pulpas digitales. En cuanto a la epidemiología, corresponde al 1 al 5% de los tumores de mano y con 65% ubicado en la región subungueal. Es más prevalente en mujeres y más frecuente en la tercera y quinta décadas de vida. Se evidenció la falta de estudios sobre los tumores glómicos en la región palmar, la falta de información nacional y la necesidad de resaltar la importancia clínica de este tema. Objetivo: Reportar el caso de un paciente con tumor glómico y enfatizar las características clínicas y el tratamiento recomendado. Metodología: El caso es una paciente mujer, negra, 61 años con dolor severo localizado en la lesión en la región hipotenar de la mano izquierda desde hace dos años. Caracteriza el dolor como perenne, niega la irradiación, mejora cuando se usa una compresa fría y empeora cuando se usa una compresa caliente. Utilizó analgésicos y antiinflamatorios, sin éxito en la mejoría clínica. El dolor se volvió intermitente y hubo intolerancia gástrica a la medicación utilizada. La condición mejoró tras acudir a un dermatólogo, quien realizó una cirugía menor para extirpar la lesión, indicando el diagnóstico de tumor glómico. Conclusión: A diferencia de este informe, en el que la lesión es palmar, la mayoría de los casos de este tumor benigno tienen lesiones subungueales y lesiones en los dedos.(AU)

Glomus faciale tumors: A report of 3 cases and literature review.

Our objectives in reporting this case series are to familiarize readers with the rare occurrence of paragangliomas originating along the facial nerve and to provide a literature review. We describe 3 such cases that occurred at our tertiary care academic medical center. Two women and 1 man presented with a tumor adjacent to the vertical segment of the facial nerve. The first patient, a 48-year-old woman, presented with what appeared to be a parotid tumor at the stylomastoid foramen; she underwent a parotidectomy, transmastoid facial nerve decompression, and a shave biopsy of the tumor. The second patient, a 66-year-old man, underwent surgery via a postauricular infratemporal fossa approach, and a complete tumor resection was achieved. The third patient, a 56-year-old woman, presented with a middle ear mass; she underwent complete tumor removal through a transmastoid transcanal approach. All 3 patients exhibited normal facial nerve function both before and after surgery. Paragangliomas of the facial nerve are extremely rare, and their signs and symptoms are unlike those of any other temporal bone glomus tumors. Management options include surgical resection, radiologic surveillance, and radiotherapy. The facial nerve can be spared in selected cases.

Glomus tumour of the stomach.

Glomus tumours are benign tumours typically arising from the glomus bodies and primarily found under the fingernails or toenails. These rare neoplasms account for <2% of all soft tissue tumours and are generally not found in the gastrointestinal tract. We report a case of a 40-year-old man presenting with recurrent epigastric pain and pyrosis. Endoscopy revealed a solitary tumour in the antrum of the stomach. Fine-needle aspiration biopsy was suspicious for a gastrointestinal stroma tumour. After CT indicated the resectability of the tumour, showing neither lymphatic nor distant metastases, a laparoscopic-assisted gastric wedge resection was performed. Surprisingly, histology revealed a glomus tumour of the stomach.

A recurred subungual glomus tumour of the thumb.

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.

Glomus tumour: a rare differential for subungual lesions.

A 21-year-old, usually fit and well man, presented with a 10-year history of intermittent, paroxysmal pain and temperature sensitivity to his right thumb. He felt this was associated with a subungual lesion present on the same digit. He was diagnosed as having a glomus tumour and was referred to the hand surgeons for surgical excision.

Glomangiopericytoma of nasal cavity.

Glomangiopericytoma/sinonasal type hemangiopericytoma is a rare sinonasal neoplasm arising from the pericytes surrounding capillaries and accounts for less than 0.5% of all sinonasal tumors. This tumor differs from conventional soft tissue hemangiopericytoma in location, biologic behaviour and histologic features. Glomangiopericytoma is a borderline low malignancy tumor with a good prognosis after complete surgical resection. We report a case of 60-year-old woman who presented with progressive nasal obstruction and frequent nasal bleeding and was diagnosed as glomangiopericytoma on histopathological and immunohistochemistry findings. Histological characteristics, differential diagnosis and prognosis of this tumor are discussed in this article. This case has been reported because of its rarity and an array of differential diagnosis.