Atypical presentation of a glomus tumour: A case report

Abstract

A 46-year-old man presented with an extremely painful, 1 cm, mobile, nodular mass located on the medial side of his right elbow. Symptoms failed to respond to conservative treatment. Ultrasound and Doppler flow imaging revealed a well-defined, round hypoechoic mass. Under local anesthesia, the mass was resected and the wound closed without complication. Final pathology diagnosed the lesion as a glomus tumour, solid type. Histology staining showed the tumour cells were positive for antibodies to vimentin and muscle actin. It is unusual for a glomus tumour to be located anterior to the medial epicondyle of the right arm. Hand surgeons most commonly encounter glomus tumours in the nailbeds of the fingers.Key Words: Case report; Glomangioma; Glomus tumour; Elbow; Extradigital tumour; Nodular mass La présentation atypique d'une tumeur glomique : Rapport de cas Un homme de 46 ans a consulté en raison d'une masse nodulaire mobile de 1 cm extrêmement douloureuse sur la partie médiale du coude droit. Les symptômes n'ont pas réagi à un traitement classique. L'échographie et le Doppler ont révélé une masse hypoéchogène ronde bien définie. Sous anesthésie locale, la masse a été réséquée, et la lésion s'est fermée sans complication. La pathologie a révélé une tumeur glomique solide. La coloration histologique a indiqué que les cellules tumorales étaient positives aux anticorps de la vimentine et de l'actine. Il est inhabituel qu'une tumeur glomique se trouve sur la face antérieure de l'épitrochlée droite. En général, les chirurgiens de la main trouvent des tumeurs glomiques sous les lits d'ongles des doigts.

Color Doppler Sonography of Extradigital Glomus Tumors

“…Most of the cases reported in the literature exhibit Doppler findings similar to those detected in our series, although only a minority of imaging articles illustrate the color Doppler findings, 2,[4][5][6][7][8]18,20,23,25,28,[33][34][35] and only three of them 18,25,35 included the spectral Doppler findings. EDGTs are usually vascularized, although to a variable degree, and are not necessarily hypervascular.…”

“…[1][2][3][4]7,[10][11][12][13][14][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Additionally, only a minority of these articles include a description of the sonography findings. 2,4,12,13,20,[22][23][24][25]27,29,30,33,34 The three largest series published that included a description of the sonography findings collected 3, 6 4, 35 and 9 18 cases of EDGT, respectively. Glazebrook et al 23 reported the sonography findings in a patients with 4 EDGTs of the leg, 2 subcutaneous and 2 intramuscular, ranging in size from 7 to 52 mm.…”

“…EDGTs are usually vascularized, although to a variable degree, and are not necessarily hypervascular. 2,4,6,18,20,23,34,35 Despite the usual small size of the lesion, several tortuous vessels are usually seen internally. 5,25,35 However, differently from hemangioma, the vessels seen in EDGT are prominent but do not appear as vascular lakes.…”

“…G lomus tumor (GT) is an uncommon vascular neoplasm arising from the dermal neuromyoarterial glomus body, a specialized arteriovenous anastomosis involved in the thermoregulation. 1,2 Glomus tumor consists of variable amounts of glomus cells, prominent branching vascular channels, and smooth muscle cells, being consequently subclassified as solid GT, glomangioma, and glomangiomyoma. 3 Glomus tumor is usually located in the subungual area of the hand.…”

Glomus tumour of the elbow: a case of mistaken identity

“…To our knowledge, this is the first case report of a glomus tumour misdiagnosed as persistent olecranon bursitis. Other reports have described glomus tumours in the forearm [15], medial elbow resulting in medial cutaneous nerve of the forearm symptoms [18] and ulnar nerve symptoms [13]. The initial symptom of a painful swelling was nonspecific and was originally diagnosed as an olecranon bursitis as a result of its location.…”