Glomus tumor of hand: A rarity treated by transungual approach
Author(s): Dr. Anand Deoraj, Kanchan Sonelal Baitha, Prem Prakash and Shubham Ranjan Anand
Abstract:Introduction: Glomus tumor is a benign and rare vascular tumor arising from the glomus body, commonly found in the hand particularly in subungal region. These tumors present usually as bluish discolouration of nail plate with classical triad of excruciating pain, localized tenderness and sensitivity to cold. It’s etiology remains unknown but several hypothesis explain the excruciating pain. Different clinical test including Love’s pin test, Hildreth’s test and trans-illumination test are often helpful in diagnosis. MRI (Magnetic Resonance Imaging) is an excellent imaging modality in the diagnosis of these lesions. Diagnosis of tumor is delayed because of subtle clinical signs and also surgeons often miss advising MRI to patients due to its high cost. There are two main approaches for excision of glomus tumor-transungual and periungual. Selection of approach depends upon surgeon’s choice and anatomical location of the tumor. Complete surgical excision of the tumor reduces chance of recurrence.
The aim of this study is to review the time from onset of symptoms to the diagnosis, management of problem and recurrence retrospectively.
Material and methods: This study was done retrospectively between May 2017 to May 2019 at tertiary care center of eastern India. All patients with histopathologic ally confirmed subungual glomus tumor of distal phalanx of hand were included in this study. Patients with Reynolds disease were excluded from this study. MRI was done preoperatively and histopathological analysis of the excised specimen was done postoperatively to confirm the diagnosis. Patients were followed-up after every 3 month for 1 year to see any complication and recurrence.
Results: It was found that the patients had clinical symptoms for an average of 2.3 years. All patients were women with mean age of 34.2 years. Out of 5 patients, 2 patients developed nail deformity. Recurrence was not found till last follow-up period. All patients were returned to their normal routine work and regained their full function of the hand.