Glomus tumours of the extremities: localisation and operative treatment in 36 cases

Abstract

Glomus tumours are rare lesions and perhaps for that reason they often pose diagnostic difficulties. They are benign tumours first described by Masson in 1924, and they are derived from the glomus body responsible for blood and temperature regulation. In this study, 36 cases were reported out of a total of more than 35 000 operations in an eleven-year period. Among them were 23 women (average age 51 years) and 13 men (average age 52 years). They were diagnosed correctly after a mean period of eight years from onset of symptoms until surgery. In women, glomus tumours occurred almost always in the distal phalanx, especially in the subungual area, in men without any predisposing localisation. Two third of the patients presented with local pain and cold intolerance, and 50 percent of the patients with subungual localisation had a bluish discoloration beneath the nail. In three patients without visible or palpable signs additional MRI confirmed the diagnosis. All patients were operated upon in local anaesthesia and in a bloodless field. In the cases with subungual localisation, we mostly used a transungual triangular incision with good cosmetic results. In 94 % of the patients the lesion has been cured, in one case symptoms persisted, and in another case recurrence occurred. Conclusion. In patients with severe local pain, especially in the distal phalanx, glomus tumours should be considered. In cases where no clinical signs can be found, MRI - although not specific - may be helpful in establishing the correct diagnosis. The operation can be performed in local anaesthesia, bloodless field and in subungual localisation through a triangular incision. Recurrences may occur.