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Altarifi ME, Kalas A, Alnajjar A, Yasin Dali M, Alkhowailed MS. Glomus tumor: A rare differential diagnosis for subungual lesions. Radiol Case Rep 2024; 19:6034-6038. [PMID: 39345850 PMCID: PMC11437606 DOI: 10.1016/j.radcr.2024.08.116] [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: 05/17/2024] [Revised: 08/20/2024] [Accepted: 08/21/2024] [Indexed: 10/01/2024] Open
Abstract
Glomus tumors are rare, benign vascular hamartomas of the glomus apparatus with unknown etiology. They can arise from anywhere in the body. However, up to 90% of them are located in the subungual region of the fingers, as in the case of our patient. These tumors typically present with the classic triad of pain, cold sensitivity, and point tenderness. Characteristic US and MRI findings aid the clinical diagnosis; nevertheless, a histopathologic examination is confirmatory. There is a well-documented mean delay in diagnosis of around 7 years, due to the rarity, benignity, small size, and lack of proper knowledge about the condition. However, we reported a case with a delay in diagnosis that reached 40 years, which is much longer than what is documented in the literature. A high index of suspicion is required for early diagnosis and management of glomus tumors to relieve the patient's long-term suffering and prevent possible secondary nail deformities. The curative treatment of glomus tumor is complete surgical excision, which is crucial to prevent recurrence and relieve the patient's symptoms.
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Affiliation(s)
- Mhd Ebrahim Altarifi
- Faculty of Medicine, Sulaiman Alrajhi University, Bukayriah, Qassim, Saudi Arabia
| | - Ammar Kalas
- Faculty of Medicine, Sulaiman Alrajhi University, Bukayriah, Qassim, Saudi Arabia
| | - Anas Alnajjar
- Department of Radiology, Graduate Medical Education, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai Health, Dubai, United Arab Emirates
| | - Majd Yasin Dali
- Faculty of Medicine, Sulaiman Alrajhi University, Bukayriah, Qassim, Saudi Arabia
| | - Mohammad S․ Alkhowailed
- Department of Dermatology, College of Medicine, Qassim University, Buraidah, Qassim, Saudi Arabia
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2
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AlNuaim B, Binsulaiman N, Alkohlani A, Al-Ghannam A, AlMohsen Z, Al-Saati M. Diagnosis of glomus tumor of the elbow: A case report. Int J Surg Case Rep 2021; 90:106709. [PMID: 34953423 PMCID: PMC8715102 DOI: 10.1016/j.ijscr.2021.106709] [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: 10/07/2021] [Revised: 12/07/2021] [Accepted: 12/14/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Glomus tumors are rare and often benign vascular lesions that present classically in the subungual region of the hand. Nonetheless, presentations in atypical sites have been reported over the years. However, the classic symptoms of typical glomus tumors are often absent in tumors of atypical sites. CASE PRESENTATION We present a case of an extradigital glomus tumor with a 3-year history of pain in the lateral aspect of the elbow. DISCUSSION The case we present took three years and multiple visits to different clinics and specialties to reach the final diagnosis and management. It often takes longer to diagnose Glomus tumors of atypical sites and presentations. The causes could be related to the rare incidence, the atypical presentation in site and symptoms, or the diagnostic methods. CONCLUSION This case report discusses the possible causes behind the diagnostic delay in extradigital glomus tumors, aiming to raise clinical awareness among primary health care physicians.
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Affiliation(s)
- Bader AlNuaim
- Section of Orthopaedic Surgery, Department of Surgery, King Abdullah Bin Abdulaziz University Hospital (KAAUH), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | | | - Abdullah Al-Ghannam
- Lifestyle and Health Sciences Research Center, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Zaid AlMohsen
- Section of Dermatology, Department of Medicine, Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | - Maad Al-Saati
- Section of Orthopaedic Surgery, Department of Surgery, King Abdullah Bin Abdulaziz University Hospital (KAAUH), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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3
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Ajala RT, Lyon KA, Lyon PR, Harris FS. Extradigital Glomus Tumor Mimics an Intrinsic Nerve Tumor in a Trauma Patient: Case Report and Literature Review. Cureus 2021; 13:e19256. [PMID: 34900456 PMCID: PMC8648149 DOI: 10.7759/cureus.19256] [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: 10/26/2021] [Accepted: 11/04/2021] [Indexed: 11/25/2022] Open
Abstract
Glomus tumors are rare, painful, and usually benign neoplasms that typically occur at the subungual aspect of digits. Rarely, glomus tumors may arise in other areas of the body. We present a case of an extradigital glomus tumor on a forearm with prior trauma that presented with symptoms of an isolated peripheral neuropathy. Our review of literature reveals how upper or lower extremity glomus tumors can mimic neuropathies secondary to intrinsic nerve tumors (schwannoma, neurofibroma, or neuroma), radiculopathies, or manifestations of a complex regional pain syndrome (CRPS). We emphasize the need to consider a broad differential diagnosis that includes glomus tumor when evaluating patients with painful dermal masses producing peripheral neuropathy or radiculopathy signs owing to the infiltrative growth pattern into or mass effect exerted on nearby nerves.
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Affiliation(s)
- Rodiyah T Ajala
- Surgery, Texas A&M University College of Medicine, Bryan, USA.,Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Kristopher A Lyon
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Priscilla R Lyon
- Pathology, Baylor Scott & White Medical Center - Temple, Temple, USA
| | - Frank S Harris
- Neurosurgery, Baylor Scott & White Medical Center - Temple, Temple, USA
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Alyaseen HN, Al Ghadeer HA, Al-Ghanim ME, Aljawad HH, Cordoba CR. Extradigital Glomangioma of the Cutaneous Chest Wall. Cureus 2021; 13:e17910. [PMID: 34660105 PMCID: PMC8509110 DOI: 10.7759/cureus.17910] [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] [Accepted: 09/03/2021] [Indexed: 11/09/2022] Open
Abstract
Glomus tumors (GTs) are rare benign tumors as a result of hyperplasia of glomus body. GT most commonly involves the subungual areas and rarely involves extra-digital sites. The clinical presentation of a glomus tumor is a triad of symptoms consisting of pain, cold intolerance, and pinpoint tenderness. Even though glomus tumors are benign, they can infrequently be malignant. Despite their benign nature, these lesions can cause disabling symptoms, therefore proper diagnosis and treatment is important. In this report, we present a 35-year-old Saudi male with a painful lesion on the right side of the chest wall at the posterior axillary line for seven years, with recent progressive growth and symptoms. Diagnosis of extra-digital glomangioma of the chest wall in this patient was confirmed by histopathology. The patient was managed by complete surgical excision of the lesion with the resolution of pain and without recurrence.
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Affiliation(s)
| | | | | | | | - Carlos R Cordoba
- Plastic Surgery, Montreal University Hospital Centre, Montreal, CAN
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5
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Zacharia B, Manickam K, Subramanyam D. Extradigital Painful Glomus Tumour of Heel Pad. Indian J Surg Oncol 2019; 10:629-631. [DOI: 10.1007/s13193-019-00953-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 07/19/2019] [Indexed: 11/30/2022] Open
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6
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Hamilton AR, Paton A, Downie JJ. Glomangioma: rare case of a painful lump in the upper lip. Br J Oral Maxillofac Surg 2019; 57:788-790. [PMID: 31345579 DOI: 10.1016/j.bjoms.2019.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 07/04/2019] [Indexed: 11/17/2022]
Abstract
Glomus tumours in the lip are extremely rare with only 13 cases, including this one, recorded in the English language that we know of. We report a 45-year-old woman with a firm, mildly painful lump in her upper lip. Excisional biopsy examination and histopathological analysis showed it to be a subtype of glomus tumour called a glomangioma.
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Affiliation(s)
- A R Hamilton
- Oral and Maxillofacial Department, Forth Valley Royal Hospital, Stirling Road, Larbert, FK5 4WR, UK.
| | - A Paton
- Oral and Maxillofacial Department, Forth Valley Royal Hospital, Stirling Road, Larbert, FK5 4WR, UK
| | - J J Downie
- Oral and Maxillofacial Department, Forth Valley Royal Hospital, Stirling Road, Larbert, FK5 4WR, UK.
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Sacchetti F, De Gori M, Grossi S, Bonadio GA, Capanna R. An exceptional case of malignant glomus tumor and a review of the literature. ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA 2019; 53:313-317. [PMID: 31155303 PMCID: PMC6739266 DOI: 10.1016/j.aott.2019.04.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 04/02/2019] [Accepted: 04/28/2019] [Indexed: 11/29/2022]
Abstract
Malignant glomus tumors (MGTs) are exceptional but pose diagnostic and therapeutic challenges. Wide resection is the recommended treatment method, however, no data are available concerning adjuvant therapies. We present an exceptional case of extradigital deep-seated MGT of the forearm, with an exceptional bone infiltration. Despite being treated with wide resection, the patient had an optimal functional outcome, no functional loss, no motor or sensitive deficits and has returned to his full daily activity.
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Affiliation(s)
- Federico Sacchetti
- Department of Orthopaedic and Trauma Surgery, University of Pisa, Italy.
| | - Marco De Gori
- Department of Orthopaedic and Trauma Surgery, University of Pisa, Italy; Department of Orthopaedic and Trauma Surgery, Hospital of Soverato, Italy
| | - Stefano Grossi
- Department of Orthopaedic and Trauma Surgery, University of Pisa, Italy
| | | | - Rodolfo Capanna
- Department of Orthopaedic and Trauma Surgery, University of Pisa, Italy
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8
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Lancien U, Duteille F, Perrot P. Extradigital glomic tumor of the forearm. About a case and review of literature. ANN CHIR PLAST ESTH 2018; 63:187-189. [DOI: 10.1016/j.anplas.2017.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/22/2017] [Indexed: 11/25/2022]
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Power FR, Ryan AG, Murphy MN, Cleary MS. Extradigital glomus tumor of the elbow with preoperative ultrasound-guided wire localization: a case report. J Shoulder Elbow Surg 2017; 26:e352-e356. [PMID: 28941972 DOI: 10.1016/j.jse.2017.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 07/17/2017] [Accepted: 07/28/2017] [Indexed: 02/01/2023]
Affiliation(s)
- Fiachra R Power
- Department of Orthopaedics, University Hospital Waterford, Waterford, Ireland.
| | - Anthony G Ryan
- Department of Radiology, University Hospital Waterford, Waterford, Ireland
| | - Maurice N Murphy
- Department of Pathology, University Hospital Waterford, Waterford, Ireland
| | - May S Cleary
- Department of Orthopaedics, University Hospital Waterford, Waterford, Ireland
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Abstract
A glomus tumor is an uncommon, predominantly benign, neoplastic lesion that primarily involves a thermoregulatory microvascular apparatus, the glomus body. Although these lesions can occur anywhere in the body, the subungual tissue of the hand represents the most common presentation site. Glomus tumors are not often encountered in the foot. Symptoms traditionally include the classic triad of pain, pressure, and cold sensitivity. This case report describes a variant location for a glomus tumor in the subcuticular tissue adjacent to the medial middle phalanx of the second toe. The nonsubungual location for this presentation should prompt the inclusion of glomus tumor in a digital soft-tissue lesion differential diagnosis. The lesion was excised surgically and was subsequently diagnosed histopathologically as a glomus tumor.
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Affiliation(s)
- Robert L.B. Sprinkle
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC
| | - Omar P. Sangueza
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Gregory A. Schwartz
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, NC
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11
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Catalano O, Alfageme Roldän F, Solivetti FM, Scotto di Santolo M, Bouer M, Wortsman X. Color Doppler Sonography of Extradigital Glomus Tumors. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:231-238. [PMID: 27914173 DOI: 10.7863/ultra.16.03023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 04/12/2016] [Indexed: 06/06/2023]
Abstract
We retrospectively collected cases of surgically proven extradigital glomus tumor (EDGT) and reviewed their demographic, clinical, and sonography features. A total of 18 single, subcutaneous EDGTs were gathered. All but one were located in the extremities. EDGTs typically appear as a small, hypoechoic, homogeneous, or slightly inhomogeneous, well-delimited nodule, disposed horizontally and painful under probe pressure. Intranodular vascularization is always present. Feeding artery and efferent vein are typical but inconstant findings.
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Affiliation(s)
- Orlando Catalano
- Department of Radiology, National Cancer Institute, Pascale Foundation, Naples, Italy
| | | | | | | | | | - Ximena Wortsman
- Departments of Radiology and Dermatology, Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Clinica Servet, University of Chile, Santiago, Chile
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12
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Lunn J, Stanton J, Arya A. Glomus tumour of the elbow: an unusual complication of surgery. Shoulder Elbow 2016; 8:197-8. [PMID: 27583019 PMCID: PMC4950281 DOI: 10.1177/1758573216640190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/29/2016] [Indexed: 11/16/2022]
Abstract
Glomus tumours of the elbow remain a challenge to diagnose correctly and efficiently. We present a case of a glomus tumour as a complication of elbow surgery. This has not been described previously. This case highlights the possibility of injury as a causative factor in these tumours and the difficulty in differentiating them from postoperative neuromas by clinical presentation and ultrasound imaging alone.
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Affiliation(s)
- Jessica Lunn
- Jessica Lunn, Department of Orthopaedics, Floor 2, Hambledon Wing, Kings College Hospital, Denmark Hill, London SE5 9RS, UK. Tel: +44 (0)20 3299 9000.
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13
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Oliveira A. Dermoscopy in the diagnosis of extradigital glomus tumors. Int J Dermatol 2016; 55:e506-8. [PMID: 27126571 DOI: 10.1111/ijd.13289] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 10/24/2015] [Accepted: 12/19/2015] [Indexed: 01/25/2023]
Affiliation(s)
- André Oliveira
- Department of Dermatology, Hospital de Santo António dos Capuchos - Centro Hospitalar de Lisboa Central, Lisbon, Portugal.
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Extradigital glomus tumor in the knee: excision with ultrasound guided needle localization. Skeletal Radiol 2015; 44:1689-93. [PMID: 26130071 DOI: 10.1007/s00256-015-2202-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 05/03/2015] [Accepted: 06/11/2015] [Indexed: 02/02/2023]
Abstract
Glomus tumors are rare neoplasms that are usually subungual in location, but can infrequently be found elsewhere in the body. When they occur in extradigital locations, they present a diagnostic challenge that may result in delay of definitive management. We report a case of a 51-year-old male who experienced decade long chronic pain because of a glomus tumor in the suprapatellar fat pad of the knee. This case is unique not only because of the glomus tumor's location, but also because it ultimately required ultrasound-guided needle localization for excision.
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15
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Oliveira A, Brás S, Milheiro A, Cardoso J. Painful purple nodule on the right thigh-Answer. Dermatol Pract Concept 2015; 5:27. [PMID: 26114052 PMCID: PMC4462899 DOI: 10.5826/dpc.0502a07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Affiliation(s)
- André Oliveira
- Department of Dermatology, Hospital de Curry Cabral-Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Susana Brás
- Department of Dermatology, Hospital de Curry Cabral-Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Adelaide Milheiro
- Department of Pathology, Hospital de Curry Cabral-Centro Hospitalar de Lisboa Central, Lisboa, Portugal
| | - Jorge Cardoso
- Department of Dermatology, Hospital de Curry Cabral-Centro Hospitalar de Lisboa Central, Lisboa, Portugal
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Abstract
Glomus tumors are benign neoplasms that arise from neuromyoarterial glomus bodies. They represent around 1–5% of all soft-tissue tumors. High temperature, sensitivity, and pain and localized tenderness are the classical triad of symptoms. Most glomus tumors represent in the subungual area of digits. Extradigital glomus tumors are a very rare entity. There are rare cases of these tumors reported to be in shoulder, elbow, knee, wrist, even stomach, colon, and larynx. We are reporting a case of a glomus tumor on thigh and discuss the histological and immunohistochemical features.
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17
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Multiple glomus tumors presenting as an aesthetic abnormality. Aesthetic Plast Surg 2015; 39:236-9. [PMID: 25673571 DOI: 10.1007/s00266-015-0453-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 01/06/2015] [Indexed: 10/24/2022]
Abstract
UNLABELLED Glomus tumors are benign soft-tissue neoplasms. Commonly found in the digits, glomus tumors can rarely arise in extradigital locations and may result in misdiagnosis or delay in diagnosis. Plastic surgeons should therefore include glomus tumors in the differential diagnosis of patients who present with painful, red- or blue-colored extradigital lesions. The authors present a rare case of extradigital glomangioma tumors of the right and left thigh in a 35-year-old woman. This case report describes an atypical presentation of multiple glomus tumors and reviews diagnostic and treatment modalities. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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