Tumeurs glomiques des membres supérieurs – évaluation des résultats cliniques et fonctionnels par une étude rétrospective monocentrique

Abstract

Glomus tumors are rare and benign hamartomas, arising from neuro-myoarterial proliferation and deriving from mesenchymal origin. As they have a long-term impact on the individual's quality of life, the primary complaint is unbearable pain. The aim of this study was to assess the clinical and functional outcomes of their surgical treatment, and to review their clinical, radiological and therapeutic features. We performed a retrospective study over a 16-year period including 31 patients with an upper limb glomus tumor. Epidemiologic, diagnostic, therapeutic and follow-up data were collected and a functional outcome questionnaire was filled out postoperatively. Thirty-one patients underwent surgery with safe macroscopic resection margins. The glomus tumor was located on the fingers in 77.4% of cases, with predominance in the ring finger (41.9% of the cases). Patient age at surgery ranged from 22 to 80 years old (mean: 54.6) with a sex ratio of 0.48. Upon clinical suspicion, magnetic resonance imaging and ultrasound were done in most cases. Immediate pain relief was obtained in 18 cases. Only one patient underwent a second surgery for incomplete removal and persistent pain. The QuickDASH questionnaire was completed by 24 patients, resulting in a mean score of 1.61, with a mean follow-up time of 88.8 months (range: 3–171 months). Seven patients were lost to follow-up. These subcutaneous, mostly subungual, nodules, with predominance on the ring finger, have a disproportionate negative impact despite their small size. The long-term outcomes after microscope-assisted surgery indicate obvious improvement in the quality of life and the patient's satisfaction, with a very low rate of recurrence.