Atypical presentation and management of a subungual glomus tumor in the pediatric population

Abstract

The glomus tumor is a rare vascular neoplasm that accounts for less than 2% of all soft tissue tumors of the hand. This is the first case study to describe the presentation and curative resection of a subungual glomus tumor in the pediatric population. The glomus tumor is classically described as a solitary subungual mass in women aged 30–50 who present with the triad of pain, temperature sensitivity, and point tenderness. However, given an infrequent and inconsistent presentation, the typical time from onset of symptoms to the correct diagnosis is 7 years, resulting in significant functional and cosmetic morbidity for patients. Here we describe an unusual case of a 6-year-old boy who presented with 3 years of pain and progressive, nontraumatic deformity of his left thumb nail. The patient underwent a left thumb nail plate removal, excision of the subungual mass, and nail bed repair. The diagnosis of subungual glomus tumor was confirmed on pathology. Glomus tumors are rare in the pediatric population but should be considered in patients presenting with nail pain and deformity. Keywords: glomus tumor, pediatric hand tumor, subungual