Ultrasonographic appearance of glomus tumors: A retrospective study

Abstract

Background: The glomus tumor is a rare neoplasm and can be easily misdiagnosed. Patients with glomus tumor may present nonspecific symptoms such as long-term pain, temperature intolerance, and history of injury. It is common for such patients to be examined by physicians from various specialties such as orthopedics, family medicine or plastic surgery. They may undergo multiple imaging studies such as plain film X-ray, ultrasonography, or magnetic resonance imaging depending on the location of the nodule. Objective: In this paper we present the first study in the Gulf Cooperation Council (GCC) region to address a retrospective institutional review of all ultrasonography studies of glomus tumors in a single medical center in the Kingdom of Bahrain between January 2013 and December 2018. Results: Out of 31 patients with glomus tumors, 11 patients underwent an ultrasonography imaging study. The sex ratio (male: female) in the group of 11 patients was 0.56:1. 63.63% (7/11) of the ultrasonography requests were done by orthopedic surgeons, whereas 27.27% (3/11) were requested by a primary care physician (PCP), and 9.09% (1/11) of the patients were referred by an emergency physician. Glomus tumors were more common in patients aged 30–39 years and 50-54 years with a mean age of (mean ± SD, 47.818 ± 12.408) years. Ultrasonography results showed that 100% (11/11) were hypoechoic. The majority of the studies showed 90.90% (10/11) with a well-defined border. Doppler US showed that 72.72% (8/11) had visible hypervascularization in the tumor, 18.18% (2/11) had moderate visible blood in the tumor, and 9.09% (1/11) had no comments on vascularity in the report. The tumor size ranged from 2.2 to 6.5 mm (mean ± SD, 4.081 ± 1.470 mm) x 1 to 4 mm (mean ± SD, 2.690 ± 1.135 mm). 90.90 % (10/11) of glomus tumors were located in the fingers. 90.90% (10/11) of the lesions were located in the left hand, whereas 9.09% (1/11) were located in the right hand and 9.09% (1/11) in the left toe. Conclusion: The results of this study were similar to those of other studies described in the literature. A well-defined, hypoechoic lesion with a hypervascular mass in the nail bed were the most common ultrasonography findings associated with subungual glomus tumors.