Subungual glomus tumors of the hand

Abstract

Background:Glomus tumors are benign hamartomas arising from the glomus body, mostly occurring in the subungual region of the digits. A triad of excruciating pain, localized tenderness and cold sensitivity is the key to diagnosing these tumors. Two surgical approaches are described in the literature for excision of subungual glomus tumors-transungual and periungual. We reviewed retrospectively the results of subungual glomus tumors of the hand treated by transungual excision.Materials and Methods:Twelve patients (9 females and 3 males) with histopathologically confirmed subungual glomus tumors of the hand were treated by transungual excision at our institute. The mean age of the patients was 40.5 years (range 28–63 years). All patients presented with pain in the nail bed and cold sensitivity. A bluish-brown discoloration was present in 6 patients. Love's pin test was positive in all and Hildreth's test was positive in 8 patients. The mean duration of followup was 38 months (range 8–72 months).Results:All patients had complete pain relief. There was no new nail deformity and no recurrence till last followup. One patient had deformity of the nail preoperatively due to previous surgery, which persisted after excision of the tumor. All of them returned to their preoperative occupation and regained full function of the hand.Conclusions:The transungual approach provides good access to the entire lesion and facilitates complete excision. Contrary to reported literature, we did not find the development of any new nail deformity with this approach.

Excision of subungual glomus tumor by subungual approach: A useful yet underutilized technique

“…MRI is the gold standard radiological investigation to confirm the clinical diagnosis, and if the underlying bone is eroded by the tumor, plain radiogram shows a clear halo and is sufficient to clinch the diagnosis. [1234567]…”

“…For centrally located lesions, the transungual approach is adopted and for lateral or peripherally located lesions, the lateral periosteal approach is adopted. [123456] Another type of excision by way of subungual approach[7] in which lesions located anywhere under the nail bed can be approached with relative ease and gives aesthetically good results is presented in this article.…”

Transungual resection of subungual glomus tumour

“…In our cases, transungual approach was used and nail bed was incised along its longitudinal axis not to disturb the nail growth. Subungual glomus tumours are treated with either transungual or periungual (lateral) approach 11. Recurrence of the tumour is usually related to incomplete excision of the tumour.…”

Glomus Tumor – Dermoscopy and Surgery

“…Surgery is the only effective method for glomus tumor treatment. For subungual lesions, both transungual and lateral subperiosteal (periungual) approach have been used successfully (16,17). Transungual surgery is the preferred method for tumors located medially, while perinugual surgery is preferred for lateral tumor position (18).…”