Glomus Tumor - A Rarity; M.R.I- A big help in early Diagnosis

Abstract

Introduction: Glomus tumor is a rare benign tumor arising from neuroarterial plexus concentrated beneath the nailbed usually in women of age group 20-40 yrs. The plexus is an arteriovenous anastomosis functioning without intermediary capillary bed, we report a case of glomus tumor affecting the nailbed of left little finger with characteristic periodic, spontaneous excruciating pain and temperature related algesia for the last 6 months. MRI helped in clinching the diagnosis at an early stage. Patient was operated for excision of the tumor making her completely pain free after resection oftumor.

Case presentation: A 40-year-old female patient came in Ortho. OPD with complaints of pain, cold algesia, and point tenderness on the radial side of base of the nailbed of left little finger for the last 6 months. Diagnosis was delayed despite the patient having sought the advice from different clinicians a number of times before coming to us. Pain used to occur on accidental touching of tender spot, cold water immersion; excruciating at times, making the patient faint. On physical examination clinical diagnosis of glomus tumor was made, which was confirmed on MRI as the plain X-ray was non-contributory.

Conclusion: Most of the glomus tumors are benign, which are amenable to cure with complete surgical excision. Rarely, if the lesion exceeds 2 cm malignant transformation of the tumor must be suspected unless proven otherwise. Delay in clinical diagnosis due to dithering on the part of the clinician unnecessarily prolong the suffering in the patient which can be greatly helped by M.R.I in clinching the diagnosis early.

Keywords: Glomus body; M.R.I hand; sucquethoyer canals.

Figure 1

Round to oval nuclei, pale eosinophilic cytoplasm and clearly defined cell margins surrounding small vessels.

Figure 2

Pre-operative image showing fingernail of left little.

Figure 3

Intra-operative image showing the mass under excision.

Figure 4

Post-operative image. Patient is now symptom free

Figure 5

M.R.I pre-contrast image.

Figure 6

M.R.I post contrast showing glomus tumor.