A painless glomus tumor: a case report

Abstract

Background: Glomus tumor is a benign and vascular hamartoma that originates from the neuromyoarterial cells of the normal glomus apparatus in the reticular dermis. The etiology of glomus tumors is unknown. It usually presents as a small, slightly raised, bluish or pinkish-red, painful nodule of the fingertips and the pulp. we report an atypical case of a patient of painless glomus tumor.

Case presentation: Our patient, a 60-year-old Moroccan man, had a 2.5 cm purplish painless soft tumor, covered with melliciric and hemorrhagic crusts, involving the first phalanx of his right index finger. This tumor was compressing his nail plate. No bony lesions were identified by radiographic studies, but magnetic resonance imaging was suggestive of glomus tumor. Surgical excision was performed with directed healing.

Conclusions: The diagnosis of a glomus tumor is an eventuality even in the absence of pain.

Keywords: Dermoscopy; Glomus tumor; Histology; Painless; Surgery.

Fig. 1

Purplish painless soft tumor, covered with yellowish hemorrhagic crusts, involving the index finger and deforming the nail

Fig. 2

Polymorphic vessels (red arrows), rainbow pattern (blue circles) with yellowish, hemorrhagic crusts (yellow arrows), and deformation of the nail (green arrows)

Fig. 3

Radiography of the hand, face and profile: no bony lesions

Fig. 4

Magnetic resonance imaging: 26 × 16 mm low tissue mass signal intensity on T1, marked hyperintensity on T2, and enhancement on T1 after gadolinium injection.

Fig. 5

Surgical excision of glomus tumor

Fig. 6

(a) Hematoxylin-eosin-saffron stain G × 200 - > Proliferation of ovoid cells (blue arrows). (b) Hematoxylin-eosin-saffron stain G × 50: Dermal proliferation getting organized around vascular clefts (blue arrows). (c) Immunohistochemistry G × 400: Antibody anti-acute myeloid leukemia (blue arrows)