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Turrini A, Staffa G, Rossi G, Capone C. Post-traumatic glomus tumor of the left anterior supraclavicular nerve: a case report. Neurol Res 2023; 45:435-439. [PMID: 36683154 DOI: 10.1080/01616412.2022.2151163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Peripheral nerve glomus tumors are extremely rare and occur with typical symptoms of peripheral neuropathic pain. Clinicians hardly consider this entity when faced with the swelling of a peripheral nerve and the diagnosis is reached only with histological examination. Nerves of limbs are usually affected and the solid glomus tumor is the most frequent histological variant. CASE DESCRIPTION A 55-year-old man presented with a glomus tumor of the anterior supraclavicular nerve of the left cervical plexus, misdiagnosed clinically and radiologically as neuroma. Despite the preoperative suspicion and the intraoperative appearance, the histological examination revealed a glomus tumor with a prevalent muscular component, a glomangiomyoma. Once the tumor was removed, pain regressed completely. CONCLUSIONS Because of its rarity, pre-operative diagnosis of glomus tumors is still a challenge, especially when arising from peripheral nerves. In the presence of chronic localized neuroma-type pain and sensitivity, glomus tumors should be considered in the pool of differential diagnosis, even if the imaging is not conclusive.
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Affiliation(s)
| | - Guido Staffa
- Department of Peripheral Nerve Surgery, Ospedale Civile degli Infermi - Faenza, Ravenna, Italy
| | - Giulio Rossi
- Department of Pathology, Ospedale Civile degli Infermi - Faenza, Ravenna, Italy
| | - Crescenzo Capone
- Department of Peripheral Nerve Surgery, Ospedale Civile degli Infermi - Faenza, Ravenna, Italy
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2
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Kwiecien GJ, Meaike J, Inwards CY, Rhee PC. Posttraumatic Glomus Tumor of the Digital Nerve with Atypical Presentation: A Case Report. JBJS Case Connect 2022; 12:01709767-202209000-00003. [PMID: 35809023 DOI: 10.2106/jbjs.cc.22.00166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
CASE A 53-year-old man sustained an injury to his left index finger and underwent presumably traumatic neuroma excision from the radial digital nerve 2 years ago. He presented with a painful mass distal to the prior site of neuroma excision with distinctly different symptoms from those that led to his index surgery. Thus, he underwent excisional biopsy of the mass which was adherent to his radial digital nerve consistent with a benign glomus tumor on histologic examination. CONCLUSION Digital nerve glomus tumors are rare. In most of the cases, some portion of the digital nerve requires excision but decreased pain can be expected.
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Affiliation(s)
| | - Jesse Meaike
- Division of Plastic Surgery, Mayo Clinic, Rochester, Minnesota
| | - Carrie Y Inwards
- Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
| | - Peter C Rhee
- Division of Hand Surgery, Mayo Clinic, Rochester, Minnesota
- Clinical Investigation Facility, Travis Air Force Base, California
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3
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Hernández V, Lena T, Camacho E, Craviotto M. Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years. REVISTA IBEROAMERICANA DE CIRUGÍA DE LA MANO 2021. [DOI: 10.1055/s-0041-1730392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.
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Affiliation(s)
- Victoria Hernández
- Plastic, Reconstructive and Esthetic Surgery Resident, Hospital de Clínicas Dr. Manuel Quintela, Plastic Surgery Department, Montevideo, Uruguay
| | - Tania Lena
- Plastic surgeon, Hospital Central de las Fuerzas Armadas, Montevideo Uruguay
| | - Eliana Camacho
- Plastic, Reconstructive and Esthetic Surgery Resident, Hospital de Clínicas Dr. Manuel Quintela, Plastic Surgery Department, Montevideo, Uruguay
| | - Matías Craviotto
- Plastic surgeon, Hospital Central de las Fuerzas Armadas, Montevideo Uruguay
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4
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Drabent P, Bielle F, Bernat I, Peyre M. Epineural glomus tumor of the posterior interosseous nerve: Case report. J Clin Neurosci 2020; 74:232-234. [PMID: 31917057 DOI: 10.1016/j.jocn.2019.12.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/30/2019] [Indexed: 11/19/2022]
Abstract
Among peripheral nerve sheath tumors, epineural glomus tumors represent a rare differential diagnosis for peripheral nerve schwannoma, displaying the same appearance on MRI. Here we present the case of a 68-year-old man complaining of pain in the left forearm, with paresthesias in the first three fingers. MRI demonstrated a round mass along the course of the posterior interosseous nerve with homogeneous contrast enhancement. Complete surgical removal successfully relieved the symptoms. Pathological analysis led to the diagnosis of glomus tumor of uncertain malignant potential. This is to our knowledge the first reported case of epineural glomus tumor of the radial nerve.
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Affiliation(s)
- Philippe Drabent
- Sorbonne Universités - Department of Neuropathology, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France
| | - Franck Bielle
- Sorbonne Universités - Department of Neuropathology, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France
| | - Isabelle Bernat
- Sorbonne Universités - Department of Electrophysiology, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France
| | - Matthieu Peyre
- Sorbonne Universités - Department of Neurosurgery, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France; Neurofibromatosis Type 2 and Schwannomatosis Referral Center, Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.
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5
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Glomus Tumor Originating from a Digital Nerve. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2019; 7:e2053. [PMID: 31624656 PMCID: PMC6635206 DOI: 10.1097/gox.0000000000002053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/12/2018] [Indexed: 11/29/2022]
Abstract
Glomus tumors are relatively rare benign neoplasms that most commonly occur in the hand. They arise from the normal glomus body, which is an arteriovenous shunt related to thermoregulation. Glomus tumors in nerves are an extremely rare occurrence, as normal glomus bodies have not been found in nerves. We describe the case of a 30-year-old woman with a glomus tumor originating from a digital nerve that required excision along with a nerve segment. In this case, because the tumor was inseparable from both fascicles of the nerve, a segment of the ulnar digital nerve was resected with the tumor. After tumor resection, direct nerve repair was performed and the patient showed favorable outcomes.
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6
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Wang Y, Lu H. Multiple intraneural glomus tumors in different digital nerve fascicles. BMC Cancer 2019; 19:888. [PMID: 31488091 PMCID: PMC6729111 DOI: 10.1186/s12885-019-6098-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 08/26/2019] [Indexed: 12/20/2022] Open
Abstract
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. Electronic supplementary material The online version of this article (10.1186/s12885-019-6098-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ying Wang
- Department of Operating Room, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China
| | - Hui Lu
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, Zhejiang Province, 310003, People's Republic of China.
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El Jouari O, Gallouj S, Elloudi S, Senhaji G, Rimani M, Mernissi FZ. A painless glomus tumor: a case report. J Med Case Rep 2018; 12:302. [PMID: 30333057 PMCID: PMC6193307 DOI: 10.1186/s13256-018-1837-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 09/06/2018] [Indexed: 01/16/2023] Open
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.
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Affiliation(s)
- Ouiame El Jouari
- Department of Dermatology University Hospital Hassan II, Fez, Morocco.
| | | | - Sara Elloudi
- Department of Dermatology University Hospital Hassan II, Fez, Morocco
| | - Ghita Senhaji
- Department of Dermatology University Hospital Hassan II, Fez, Morocco
| | - Mouna Rimani
- Hassan Center of Anatomopathology, Rabat, Morocco
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Muthiah S, Hussain R, Stefanos N, Husain A. An incidental finding of an asymptomatic intraneural glomus tumor: A case report and review of the literature. J Cutan Pathol 2018; 45:269-273. [DOI: 10.1111/cup.13097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 11/22/2017] [Accepted: 12/06/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Siobhan Muthiah
- Department of Dermatology; Royal Victoria Infirmary; Newcastle upon Tyne UK
| | - Rima Hussain
- Department of Pathology; Royal Victoria Infirmary; Newcastle upon Tyne UK
| | - Niki Stefanos
- Department of Pathology; Royal Victoria Infirmary; Newcastle upon Tyne UK
| | - Akhtar Husain
- Department of Pathology; Royal Victoria Infirmary; Newcastle upon Tyne UK
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9
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Glomangiomatosis of the sciatic nerve: a case report and review of the literature. Skeletal Radiol 2017; 46:807-815. [PMID: 28303299 DOI: 10.1007/s00256-017-2594-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 01/19/2017] [Accepted: 02/07/2017] [Indexed: 02/02/2023]
Abstract
Glomus tumors are hamartomas, which tend to occur in sites rich in glomus bodies, such as the subungual regions of digits or the deep dermis of the palm, wrist, forearm, and foot. Very rarely, they may involve peripheral nerves. We describe a patient, who, following surgical resection of a solitary glomus tumor of the left distal sciatic nerve in his teens, had recurrence with development of multiple tumors in the course of the nerve over several years. To our knowledge, this is the only known case of glomangiomatosis involving a major peripheral nerve.
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10
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Mitchell CH, Fayad LM, Ahlawat S. Magnetic Resonance Imaging of the Digital Nerves of the Hand: Anatomy and Spectrum of Pathology. Curr Probl Diagn Radiol 2017; 47:42-50. [PMID: 28438411 DOI: 10.1067/j.cpradiol.2017.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 01/20/2023]
Abstract
Digital nerves are intrinsic to the sensory and motor function of the hand. These nerves represent the terminal ramifications of the ulnar, median, and radial nerves and are located distal to the carpal tunnel and Guyon canal. With magnetic resonance imaging, traumatic and nontraumatic abnormalities of the digital nerves can be shown with high contrast as well as high spatial resolution. Digital nerve abnormalities are most commonly posttraumatic in nature; however, infection, inflammatory, vascular malformations, and neoplasms can rarely occur. Magnetic resonance imaging is playing an increasing role in the assessment of peripheral nerve injury throughout the body, and in the hand, which can accurately identify the extent and character of digital nerve abnormalities before operative intervention.
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Affiliation(s)
- Charles H Mitchell
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Laura M Fayad
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD
| | - Shivani Ahlawat
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD.
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11
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Glomus tumor of digital nerve - a case report. J Hand Microsurg 2014; 6:106-7. [PMID: 25414562 DOI: 10.1007/s12593-014-0136-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 05/06/2014] [Indexed: 10/25/2022] Open
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12
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Laughlin RS, Suanprasert N, Dyck PJB, Spinner RJ, Folpe AL. Glomangiomatosis of the sural nerve. J Clin Pathol 2013; 67:190-2. [DOI: 10.1136/jclinpath-2013-201967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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13
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Wong GNL, Nandini CL, Teoh LC. Multiple intraneural glomus tumors on a digital nerve: case report. J Hand Surg Am 2013; 38:1972-5. [PMID: 24079525 DOI: 10.1016/j.jhsa.2013.07.024] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 07/20/2013] [Accepted: 07/23/2013] [Indexed: 02/02/2023]
Abstract
Glomus tumors are soft-tissue tumors that are commonly found in the hand. Intraneural glomus tumors, however, are rare, and the few reported cases are mostly solitary tumors. We present a woman with a symptomatic swelling on her finger whose imaging findings suggested multiple tumors on the digital nerve, most compatible with a neuroma. Surgical excision and histology, however, confirmed the presence of multiple glomus tumors of the digital nerve. The patient's symptoms resolved after surgery. We describe the biology, typical presentation, and clinico-pathologic features of glomus tumors associated with a peripheral nerve and explore issues that the clinician should consider with multiple tumors.
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Affiliation(s)
- Gloria N L Wong
- Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore.
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