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Joyson Dr K, Prabhu AJ, Pallapati SCR. En Bloc Excision and Bone Grafting for Monostotic Multiple Intraosseous Glomus Tumors of the Distal Phalanx: A Case Report. JBJS Case Connect 2024; 14:01709767-202403000-00008. [PMID: 38207083 DOI: 10.2106/jbjs.cc.23.00379] [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: 01/13/2024]
Abstract
CASE Glomus tumors of the hand are rare tumors that occur predominantly in the subungual region. Though multicentric glomus tumors have been reported in the subungual region involving the nailbed, monostotic multiple intraosseous glomus tumors have not been reported so far. We report a case of a 36 year-old woman who presented with a 5-year history of intermittent thumb pain, aggravated with exposure to cold or pressure. A glomus tumor of the thumb was excised, but symptoms returned 3 months later. She ultimately underwent curettage with bone grafting of a recurrent glomus tumor at the same site, and has been free of symptoms for 1.5 years. CONCLUSION Intraosseous glomus tumors may present as multiple synchronous lesions. This, to the best of our knowledge, is the first case report of monostotic multiple intraosseous glomus tumors.
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Affiliation(s)
- Kathir Joyson Dr
- Dr Paul Brand Centre for Hand Surgery, Leprosy Reconstructive Surgery and Peripheral Nerve Surgery, Department of Hand Surgery, Christian Medical College Hospital, Vellore, Tamil Nadu, India
| | | | - Samuel C Raj Pallapati
- Dr Paul Brand Centre for Hand Surgery, Leprosy Reconstructive Surgery and Peripheral Nerve Surgery, Department of Hand Surgery, Christian Medical College Hospital, Vellore, Tamil Nadu, India
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Garcia LC, Fernandes ENDS, Sobreira NDP, Bittencourt FV. Extradigital glomus tumor: dermoscopic description and histopathological correlation. An Bras Dermatol 2021; 96:765-767. [PMID: 34563419 PMCID: PMC8790217 DOI: 10.1016/j.abd.2020.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 11/17/2022] Open
Abstract
Glomus tumors are rare benign neoplasms arising from the neuromyoarterial structure called glomus body. They present as angiomatous papules, soft and painful, especially to cold and pressure. In general, they are solitary and affect the extremities, located mainly the subungual bed. Extradigital lesions are rare and can constitute a diagnostic challenge. This is the report of a patient with an extradigital lesion on the left arm, and its dermoscopic aspects, including angiomatous lagoons circumscribed by a pale halo, a structure not previously described in the two reports of extradigital glomus tumor with dermoscopic features, found in the literature.
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Affiliation(s)
- Lucas Campos Garcia
- Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Abstract
UNLABELLED Glomus tumors are painful, benign neoplasms that frequently are associated with delayed diagnosis. Commonly in the hand, they rarely present in the foot. The purpose of this case series is to characterize the clinical presentation, radiology, pathology, and surgical outcomes associated with foot glomus tumors. We reviewed our pathology database for patients with foot glomus tumors diagnosed between 1995 and 2013. Medical records including physician notes, pathology, and radiology were reviewed. Eleven patients had foot glomus tumors excised at our institution during the study period. The mean age was 45.4 (range = 28-60) years. One patient was lost to follow-up. Mean follow-up for the remaining 10 patients was 44.7 (range = 3-142) months. Ten tumors were located in the subungual region, while 1 was located in the plantar pulp of the distal phalanx. All patients presented with pain. Point tenderness, cold hypersensitivity, and nail abnormalities were variably documented but frequently present. Four patients had had prior surgery for an ingrown toenail prior to presentation at our institution. Six patients had preoperative magnetic resonance imaging studies, which were diagnostic of glomus tumor in all cases except one. Radiographs failed to provide diagnosis in all 8 patients for whom they were obtained. Postoperatively, all patients had complete symptom relief with no recurrences.In conclusion, this case series demonstrates that foot glomus tumors frequently present with classic symptoms including pain, point tenderness, and cold hypersensitivity. When clinically suspected, magnetic resonance imaging should be obtained. Marginal excision results in symptom relief and cure. LEVEL OF EVIDENCE Therapeutic, Level IV: Case series.
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Affiliation(s)
- Samir K Trehan
- Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York
| | - Dylan S Soukup
- Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York
| | - Douglas N Mintz
- Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York
| | - Giorgio Perino
- Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York
| | - Scott J Ellis
- Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York
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Horne ZD, Karam SD, Rashid A, Snider JW, Lax A, Ozdemirli M, Harter KW. The use of stereotactic body radiation therapy for local control of glomangiomatosis: a case report. Front Oncol 2013; 3:26. [PMID: 23467385 PMCID: PMC3588111 DOI: 10.3389/fonc.2013.00026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2012] [Accepted: 02/02/2013] [Indexed: 12/31/2022] Open
Abstract
The vast majority of glomangiomas are small, benign neoplasms that can occur anywhere in the body but typically arise in the subcutaneous tissues of the extremities and are capable of causing extreme pain. Typically, these lesions are managed surgically with excellent rates of tumor control. On occasion, patients present with a variant of the glomangioma tumor consisting of numerous or recurrent nodules, a condition classified as glomangiomatosis. The authors present a case report of a young patient with multiply recurrent painful glomangiomas of the left foot, who was ultimately diagnosed with glomangiomatosis pedis. After multiple surgeries and surgical consultations, no surgery other than amputation was recommended. Therefore, the patient sought consultation with regard to stereotactic body radiation therapy (SBRT). In the absence of other options, and based on its effectiveness in treating glomus tumors of the head and neck which display similar natural history and histologic features, SBRT was offered. The patient underwent SBRT to the largest of his remaining tumors with excellent local control and significant reduction in pain at two and a half years follow-up.
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Affiliation(s)
- Zachary D Horne
- Department of Radiation Medicine, Georgetown University Hospital Washington, DC, USA
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