Improvement in quality of life after surgery for glomus tumors of the fingers

Abstract

Glomus tumors are benign and rare tumors that develop through a neuro-myo-arterial glomus. Complete surgical excision of the tumor remains the standard intervention. Due to the difficulty of diagnosis, management is often late, resulting in poor quality of life. This study aimed to assess improvement in quality of life after surgery in patients with glomus tumors. We performed a retrospective study from 1992 to 2011 to analyze 23 glomus tumors of the upper limbs in 22 patients. Pain was systematically the predominant symptom. Quality of life and disability were assessed preoperatively and postoperatively using two questionnaires in 11 patients: the Medical Outcome Study Short Form (SF-36 French version) and the Cochin Hand Functional Disability Scale. An evaluation of the visual analog scale (VAS) completed the study. The average age of patients was 48years with a sex ratio of 0.28. The location of the tumor was in the fingers in 20 (87%) cases. The average delay between onset of symptoms and surgery was 8.5years. Patients consulted an average of 2.8 practitioners. The average preoperative VAS was 8.7, whereas it was 0.8 postoperatively. Eleven patients were evaluated using the assessment scales, a mean of 11 years after surgery. Pain disappeared in 10 patients (91% of cases). A limitation of physical effort before surgery was found in five (45%) patients, while one patient (9%) had such limitation for a long period after surgery (P=0.006). The improvement in fine motion was also significant (P=0.03). Surgery had a positive impact on the emotional life of three patients (27%). Discomfort arose in the social life of four (36%) patients before surgery vs. one (9%) after surgery. Glomus tumors are rarely diagnosed during the first visit, leading to misdiagnosis and deterioration in quality of life, a cause of chronic pain, and limitations in activity. The significant improvement in quality of life provided by surgery necessitates earlier diagnosis of this tumor.