Abstract
Background:
Glomus tumours of the hand are rare benign vascular tumours. The literature shows a limited number of case series with few patients treated over several years.
Methods:
Patient records and the literature were reviewed.
Case Series:
We present a series of 5 patients with glomus tumour treated over a period of 1 year. All 5 patients presented with a similar history. They were all seen by various medical practitioners for an extended period of time before presenting to the Hand Unit of our institution. All 5 patients had classical symptoms and signs of glomus tumour i.e. pain, cold intolerance and pin-point tenderness over the nail bed, while 4 of the 5 had a purplish spot seen through the nail plate. All 5 tumours were excised and the histology confirmed our pre-operative diagnosis of glomus tumour. In all of them, complete resolution of symptoms was the final outcome and there was no reported recurrence of symptoms in the short period of follow-up.
Discussion and conclusion:
Glomus tumours are rare benign vascular tumours. The limited number of case series in the literature report small numbers of patients treated at institutions over long periods of time. It can occur anywhere in the body, but up to three quarters of them are found in the hand. It arises from the neuromyoarterial glomus cells of the nailbed dermis. The triad of pain, cold intolerance and pin-point tenderness is highly suggestive of the condition. Subjective symptoms typically exceed clinical signs for which the diagnosis is delayed for months. Sometimes the tumour is visible through the nail plate appearing as reddish or purplish spot of few millimeters or as longitudinal streaks. Imaging studies except MRI are not very helpful and one must rely on a history of cold intolerance and clinical findings like pin-point tenderness for diagnosis.
