Authors: Johannes F. Dayrit, MD, FPDS; Lunardi Bintanjoyo, MD; Jerome P. Acosta, MD, DPDS; and Charles A. C. Villamin, MD, FPOA

Abstract

Introduction: Glomus tumor arises from glomus body and commonly arises on the nailbed but extradigital locations may be involved.

Case Summary: The first case is a 32-year old female with a 1-year history of severe pain on the right thumb upon pressure or exposure to cold objects. A subungual reddish-blue papule was noted. The second case is a 35-year old male with a 2-year history of solitary bluish papule on the right thigh with severe pain upon touch. Pressing with a pinhead and cold-sensitivity test elicited pain in both cases. Dermoscopy of the second case showed a multicolored structureless pattern consisting of a purple center surrounded by whitish and brown areas. A soft tissue mass on the first digit of right hand was noted in X-ray of the first case. Surgical excision was done on the first case. Skin punch biopsy was done on second case. Histopathology in both cases revealed nodules in the dermis composed of blood vessels lined by normal endothelium and surrounded by uniformly round cells with pale eosinophilic cytoplasm, clearly defined cell margins and central nuclei. These findings were consistent with a diagnosis of glomus tumor. No recurrence of lesions was noted.

Conclusion: Glomus tumor presents as reddish-blue papule(s) with pain, sensitivity to cold and pinpoint tenderness. It commonly affects subungual areas. Extradigital locations may be involved. Dermoscopy is helpful to establish the diagnosis. Imaging may be necessary to determine location and extent of the tumor. Routine histopathology is usually adequate to validate the clinical and dermoscopic diagnosis. Complete excision results in cessation of pain and decreased risk of recurrence. Malignant glomus tumor is rare.

Citation

Dayrit, J., Bintanjoyo, L., Acosta, J. & Villamin, CA (2017). Touch me not: a report on 2 cases of glomus tumors showing variation in clinical presentation. Journal of the Philippine Dermatological Society, 26(2), 81-83.

Keywords

Glomus tumor, nails, dermoscopy

1. Morais P, Peralta L, Bettencourt H, Mora A. Congenital multiple glomangiomatosis of the breast arranged in a segmental pattern. Int J Clin Dermatol Res. 2015;3(6):76-7
2. Bezati B, Fida M, Pupo L, Topi G, Bezati E, Sinani D. Subungual solitary glomus tumor. Int J Med Res Pharm Sci. 2015;2(7):16-21
3. Oliviera A, Bras S, Milheiro A, Cardoso J. Painful purple nodule on the right thigh – answer. Dermatol Pract Concept. 2015;5(3):27
4. Maehara LN, Ohe EMD, Enokihara MY, Michalany NS, Yamada S, Hirata SH. Diagnosis of glomus tumor by nail bed and matrix dermoscopy. An Bras Dermatol. 2010;85(1):236-8
5. Azmi AKK, Prakash C. A rare case of glomangioma around the knee. Brunei Int Med J. 2015;11(6):315-8
6. Hazani R, Houle JM, Kasdan ML, Wilhelmi BJ. Glomus tumors of the hand. Eplasty. 2008;8:e48
7. Fawzi R, Chandran PA, Ahmad TS. Glomus tumour: a retrospective review of 15 years experience in a single institution. Malays Orthop J. 2011;5(3):8-12
8. Shin DK, Kim MS, Kim SW, Kim SH. A painful glomus tumor on the pulp of the distal phalanx. J Korean Neurosurg Soc. 2010;48(2):185-7
9. Chun JS, Hong R, Kim JA. Extradigital glomus tumor: a case report. Mol Clin Oncol. 2014;2:237-9
10. DebBarman P, Das A, Shome K, Gharami RC. SkIndia quiz 14, solitary painful skin-colored nodule over the chest. Indian Dermatol Online J. 2014;5(3):354-5
11. McCleskey MP. Painful nodules on the trunk of an adult. J Am Acad Dermatol. 2010;62(5):904-6
12. Calonje E, Brenn T, Lazar A, McKee PH. McKee’s Pathology of the Skin with Clinical Correlations. 4th ed. China: Elsevier Saunders; 2012. pp. 1571–4.
13. Weedon D. Chapter 23: insert name of chapter In: Weedon D, editor. Weedon’s Skin Pathology, Third Edition China: Churchill-Livingston-Elsevier: 2010. p. 827.

More Articles