Posterior Cervical Glomus Tumor Mimicking Neurogenic Occipital Pain

Abstract

Glomus tumors, typically localized in digits, palms, and soles, rarely occur in the posterior cervical region. This case report describes a unique presentation of an epithelioid glomus tumor in a 49-year-old male with a history of progressive occipital headaches. A 49-year-old male, referred with a five-year history of worsening occipital headaches, presented a palpable lesion in the right suboccipital area. MRI identified a 2.3 cm subcutaneous lesion adjacent to the right occipital artery, raising initial suspicion of a schwannoma. Subsequent excisional biopsy unveiled an unexpected diagnosis - an epithelioid glomus tumor. The rarity of glomus tumors in the posterior cervical region, coupled with their potential to mimic neurogenic tumors like schwannomas, underscores the diagnostic complexity. This encounter of a glomus tumor in an uncommon posterior cervical location serves as a pertinent reminder for neurosurgeons to consider atypical differentials. This case underscores the need for heightened clinical vigilance when faced with unusual presentations in neurosurgical practice.

Keywords: glomus tumor; neurogenic pain; neurosurgery; pain management; rare tumors.

Figure 1. T2 FLAIR axial (A) and sagittal (B) MRI images highlighting a posterior subcutaneous hyperintense lesion.

The figure illustrates the T2 FLAIR axial (A) and sagittal (B) MRI images highlighting a posterior subcutaneous hyperintense lesion that borders the right occipital artery, as indicated by the yellow arrows. FLAIR: fluid-attenuated inversion recovery.

Figure 2. T1-weighted MRI images before (B) and after (A) gadolinium administration showing homogenous enhancement of the lesion.

The figure illustrates T1-weighted MRI images before (B) and after (A) gadolinium administration showing a homogenous gadolinium enhancement of the lesion, as highlighted by the yellow arrows.