Extradigital glomangiomyoma of the forearm mimicking peripheral nerve sheath tumour and thrombosed varicose vein

Abstract

Extradigital glomus tumour is uncommon, little-known outside of its subungual location, and may present without its classic triad of tenderness, cold sensitivity and paroxysmal pain. Imaging is non-specific and diagnosis is often delayed, sometimes for years, leading to unnecessary morbidity. Surgical excision is the treatment of choice, although technique depends on case specifics. Histological subtypes depend on the relative prominence of glomus cells, vascular structures and smooth muscle. The vast majority of glomus tumours are benign. We highlight the importance of considering extradigital glomus tumours when generating differential diagnoses of an atypical painful lesion in a variety of clinical specialties.

Glomus Tumor of the Lower Extremity Previously Misdiagnosed as Complex Regional Pain Syndrome in Close Proximity to a Myxofibrosarcoma: A Case Report

“…In several reported cases of lower extremity glomus tumor, MRI of the painful regions was often done several months to years after the patient began experiencing pain. [19][20][21] Unfortunately, the patient in this case experienced a delay in diagnosis as well.…”

“…17 Although typical glomus tumors share the triad of pain, point tenderness, and cold hypersensitivity, 18 extradigital glomus tumors are rarer and often do not share this constellation of symptoms. 19,20 Extradigital glomus tumors can appear in the upper and lower extremities and multiple other sites in the body. 21 Owing to their unusual nature and nonuniform symptoms, they tend to present with a longer duration of time to diagnosis.…”

Blue Nodules on the Forearms in an Active-Duty Military Servicemember

“…1 Glomus tumors generally are benign neoplasms of the glomus apparatus, and glomus cells function as thermoregulators in the reticular dermis. 2 Glomus tumors comprise less than 2% of soft tissue neoplasms and generally are solitary nodules; only 10% of glomus tumors occur with multiple lesions, and among them, glomangiomyoma is the rarest subtype, presenting in only 15% of cases. 2,3 The 3 main subtypes of glomus tumors are solid, glomangioma, and glomangiomyoma.…”

“…2 Glomus tumors comprise less than 2% of soft tissue neoplasms and generally are solitary nodules; only 10% of glomus tumors occur with multiple lesions, and among them, glomangiomyoma is the rarest subtype, presenting in only 15% of cases. 2,3 The 3 main subtypes of glomus tumors are solid, glomangioma, and glomangiomyoma. 4 Clinically, the lesions may present as small blue nodules with associated pain and cold or pressure sensitivity.…”

“…The small size of the lesions may result in difficulty establishing a clinical diagnosis, particularly if there is no hand involvement, where lesions most commonly occur. 2 Therefore, histopathologic evaluation is essential and is the best initial step in evaluating glomangiomyomas. 4 Biopsy is the most reliable means of confirming a diagnosis 2,4,5 ; however, diagnostic imaging such as a computed tomography also should be performed if considering blue rubber bleb nevus syndrome due to the primary site of involvement.…”