Where is the Lesion? Glomus Tumours of the Hand

Abstract

Glomus tumours are vascular hamartomas that are commonly found in the hand, particularly the subungual region. They appear as solitary or multiple tumours, and often present as a bluish discoloration of the nail plate. Different diagnostic tests are outlined, as well as imaging studies such as magnetic resonance imaging and ultrasound. Misdiagnosis and delayed diagnosis of these tumours are common, while a familial tendency is a potential risk factor but not yet proven. Complete surgical excision often results in complete symptomatic relief, while recurrences are largely due to incomplete excision or the growth of a new glomus tumour. This article aims to review the key aspects of glomus tumours and provide a diagnostic algorithm so that the lesion can be recognized and treated earlier.

Glomus tumours of the hand: Review of literature

“…18 In a study conducted by Netscher et al, 17 it was found that the Cold sensitivity test had 100% sensitivity, specificity, and accuracy. The Love's pin test was found to be 100% sensitive with 78% accuracy.…”

Glomus tumour: a rare differential for subungual lesions

“…In addition, there is reported to be up to a 10% recurrence rate, thought to be due to incomplete excision 3. The ability to provide a complete excision can get complicated if undertaking an initial diagnostic punch biopsy, as the glomus tumour can occasionally have poorly defined margins leaving residual tumour to regrow, facilitating the requirement for further surgery 5 6…”

Outcome of Microscopic Excision of a Subungual Glomus Tumor

“…[1][2][3][4] Typically, they occur as encapsulated solitary lesions. Up to 75% of the tumors occur in the hand, mainly on the subungual area of the fingertips.…”

“…2 Surgical excision of the tumor is recommended and considered a curative treatment. As the tumor increases in size, it may induce nail deformity or phalangeal bone indentation.…”