Fact-sheet: Glomus tumor
Updated on 02/18/2020 at 12:16 PM
Note : 0/10
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Definition
Benign tumor of the digital extremities: hamartoma arising from the glomus body, a neuromyoarterial receptor (a millimeter-sized organ involved in thermoregulation)
Accounts for 1.2% of hand tumors.
Small tumors (3 to 6 mm) whose diagnosis is often difficult.
Sex: female (60%).
Age: mean of 40 years (22-65 years).
Side: left+++
Locations:
- 70% subungual
- 20% pulp
- 10% lateral pulp
Clinical features
Pain:+++
- spontaneous: intense, sudden, lancinating
- provoked by pressure over the lesion site
- locoregional irradiation+++
- limitation of functional activity
Physical findings:
- Subungual glomus tumor: bluish or reddish discoloration, nail dystrophy
- Pulp glomus tumor: budding swelling, indurated swelling, bluish discoloration
Associated signs:
- Trophic disturbances such as digital hypotrophy
- Vasomotor signs
Radiography
- Bone erosion of the distal phalanx
- May show regular scalloping or overlying soft tissue thickening
Ultrasound
- Round hypoechoic or anechoic formation, with small internal cystic changes.
- Doppler: marked hyperemia ++
CT
Useful for demonstrating atypical intravisceral locations: hypervascular nodule
MRI
- T1: hypointense
- T2: hyperintense
- marked enhancement after Gadolinium injection as early as the arterial phase
- Visibility of numerous perilesional vessels reflecting its hypervascularity
Management
- Complete surgical excision
- Diagnostic confirmation: pathology
- Recurrence possible with a less typical appearance of glomus tumor.
Differential diagnosis
- Ganglion cyst
- Venous malformation
- Soft tissue chondroma
- Giant cell tumor
- Epidermoïd cyst
- Neuroma / Schwannoma
- Subungual melanoma
