Intravascular Glomus Tumor of the Forearm Causing Chronic Pain and Focal Tenderness

Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition.Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI) showed a mass measuring 5 × 3 × 2 mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient’s symptoms were completely resolved postoperatively.Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis.

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Digital Glomus Tumor: Bibliographic Review of the Studies Published over the Past 10 Years

Revista Iberoamericana de Cirugía de la Mano ◽

10.1055/s-0041-1730392 ◽

2021 ◽

Vol 49 (01) ◽

pp. 046-055

Author(s):

Victoria Hernández ◽

Tania Lena ◽

Eliana Camacho ◽

Matías Craviotto

Keyword(s):

Glomus Tumor ◽

Case Reports ◽

Low Frequency ◽

Benign Neoplasm ◽

Surgical Excision ◽

Soft Tissue Tumors ◽

Glomus Tumors ◽

The Past ◽

Pubmed Search ◽

Magnetic Resonance Imaging Mri

AbstractGlomus tumors are a mostly benign neoplasm that constitutes less than 4% of upper-limb soft-tissue tumors. Its unspecific clinical presentation, added to its low frequency, leads to a late diagnosis.The objective of the present study is to update the clinical-paraclinical approach and the surgical technique used in the treatment.We carried out a literature review from 2014 to 2019 on digital glomus tumor in the hand in adult patients using the PubMed search engine.In most of the publications analyzed, the diagnosis was clinical, with a delay of 1 to 10 years. Plain radiography is the most requested study; of the 16 articles reporting its indication, only half evidenced compatible changes. Magnetic resonance imaging (MRI) was requested in 15 articles, presenting normal results in 3 of them. The treatment of choice was surgical excision using a transungual approach. Only 4 articles report recurrence after excision.Although there is diversity in the approach to these tumors, we conclude that the diagnosis is clinical, and the treatment surgical, and there is no consensus regarding the paraclinical indication. The information available comes mainly from case reports, publications that contribute to the generation of evidence for the clinical practice in rare diseases such as this one.

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An Unusual Case of Periosteal Glomus Tumor at the Metacarpal Base Presenting as Type II CRPS: Case Report

Hand ◽

10.1177/1558944719895618 ◽

2020 ◽

pp. 155894471989561

Author(s):

Dean W. Smith

Keyword(s):

Chronic Pain ◽

Unusual Case ◽

Glomus Tumor ◽

Hand Function ◽

Correct Diagnosis ◽

Pain Syndrome ◽

Surgical Excision ◽

Pain Patient ◽

Glomus Tumors ◽

Chronic Regional Pain Syndrome

Background: An unusual case involving a middle-aged male with a 9-year history of presumptive chronic regional pain syndrome (CRPS) and ulnar neuropathy was referred for failure in treatment. Methods: On presentation, the patient was requesting an amputation of his arm. However, work-up uncovered a periosteal extra-digital glomus tumor on the base of the small finger metacarpal. Results: Surgical excision of the lesion resulted in rapid resolution of his pain and normal hand function was ultimately restored. Conclusions: Glomus tumors account for up to 5% of all soft tissue tumors of the upper extremity, occurring most frequently within or adjacent to the nail bed. Time from onset of symptoms to correct diagnosis may not be established for many years, especially with atypical tumor locations. Although glomus tumors have been widely reported, atypical locations of these tumors should be included in the differential diagnosis for patients with unusual chronic pain or neuropathy. Furthermore, when evaluating a chronic pain patient, our findings support the opinion that assignment of the diagnosis of CRPS should only be a diagnosis of exclusion.

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CT and MRI imaging of glomus tumors of the temporal bone

Medical Visualization ◽

10.24835/1607-0763-2018-3-26-32 ◽

2018 ◽

pp. 26-32

Author(s):

E. A. Stepanova ◽

М. V. Vishnyakova ◽

V. I. Sambulov ◽

I. Т. Mukhamedov

Keyword(s):

Magnetic Resonance ◽

Diagnostic Imaging ◽

Temporal Bone ◽

Glomus Tumor ◽

Magnetic Resonance Tomography ◽

Mri Imaging ◽

Glomus Tumors ◽

Magnetic Resonance Imaging Mri ◽

Temporal Bone Tumor ◽

Ct And Mri

Glomus tumor is one of the most common temporal bone tumors. Most of them are benign and locally invasive, some are occasionally able to metastasize and have signs of malignancy. Diagnostic imaging is necessary before treatment. Computer tomography (CT) is traditionally used as a primary method of diagnosis, to recognize changes in the temporal bone. Role of magnetic resonance imaging (MRI) in temporal bone tumor diagnosis is not definitively determined.Purpose. To assess the possibilities of computer and magnetic resonance tomography, to develop an algorithm for the application of diagnostic imaging methods in the diagnosis of glomus tumors of the temporal bone.Material and methods. The article presents the experience of diagnosing 30 patients with glomus tumors.Results. The tympanic form of the glomus tumor was observed in 11 cases (37%), tympano-yugular in 19 cases (63%). CT and MRI data totally coincided in cases of small tumors (type A and B). In the presence of extended forms CT ability of assessing bone invasion, involvement of the internal carotid artery, internal jugular vein, and dural sinuses was lower than the MRI.

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Primary Occipital Ewing’s Sarcoma with Subsequent Spinal Seeding

Case Reports in Pediatrics ◽

10.1155/2017/1521407 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Ali Alqahtani ◽

Roaa Amer ◽

Eman Bakhsh

Keyword(s):

Posterior Fossa ◽

Ewing’S Sarcoma ◽

Ewing's Sarcoma ◽

Bone Cancer ◽

Surgical Excision ◽

Good Prognosis ◽

Bone Lesions ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Whole Spine

Ewing’s sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing’s sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT) imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) seeding from the L5 to the S4 vertebrae. Primary cranial Ewing’s sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing’s sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing’s sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.

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Subungual Glomus Tumor- Clinical Presentation And Treatment

Bangladesh Journal of Plastic Surgery ◽

10.3329/bdjps.v3i2.18250 ◽

2014 ◽

Vol 3 (2) ◽

pp. 45-48 ◽

Cited By ~ 1

Author(s):

Shyamal Chandra Debnath ◽

Suman Kumar Roy ◽

RR Kairy

Keyword(s):

Soft Tissue ◽

Soft Tissue Tumor ◽

Clinical Presentation ◽

Glomus Tumor ◽

Rare Condition ◽

Surgical Excision ◽

Tissue Mass ◽

Delay In Diagnosis ◽

Nail Deformity

Glomus tumor is a rare condition and constitutes only 1 % of all soft tissue tumor of body. Glomus tumor is familiar for its unusual presentation and long standing symptoms due to delay in diagnosis. Authors have presented the clinical behavior and treatment of 7 patients with subungual soft tissue mass. Following surgical excision, all patients cured of symptoms, at the end of follow up, no recurrence occurred; post operative nail deformity was insignificant. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18250 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 45-48

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Non traumatic spinal epidural haematoma

Acute Medicine Journal ◽

10.52964/amja.0787 ◽

2019 ◽

Vol 18 (4) ◽

pp. 255-258

Author(s):

Naureen Abdul Khalid ◽

◽

Nainal Shah ◽

Keyword(s):

Magnetic Resonance Imaging ◽

Trauma Surgery ◽

Epidural Haematoma ◽

Rare Condition ◽

Sudden Onset ◽

Resonance Imaging ◽

Spinal Epidural Haematoma ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Spinal Epidural

Spinal epidural haematoma is a rare condition, which may be due to trauma, surgery, epidural catheterisation or disorders of coagulation. We report a case of 60 year old lady who was on warfarin for Atrial fibrillation (AF) presented with history of non-traumatic sudden onset pain in both legs and difficulty in walking. Magnetic resonance imaging (MRI) spine demonstrated epidural haematoma which was treated conservatively. Another dilemma was anticoagulation for AF. We examine the options to manage such case.

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A case of retroperitoneal tumor – clinical and therapeutic considerations

ARS Medica Tomitana ◽

10.1515/arsm-2016-0034 ◽

2016 ◽

Vol 22 (3) ◽

pp. 203-207

Author(s):

R. Osman ◽

V. Sarbu ◽

S. Osman

Keyword(s):

Rare Condition ◽

Surgical Excision ◽

Retroperitoneal Tumor ◽

Lumbar Pain ◽

Pathological Examination ◽

Nerve Sheath Tumor ◽

Abdominal Girth ◽

Computed Tomographic ◽

Appropriate Treatment ◽

History Of

Abstract Introduction: The aim of this paper is to present a case of rare retroperitoneal tumor. Material and Methods. A 72 year old man presented with six month history of abdominal girth, lumbar pain and occasional episodes of constipation was admitted in our clinic. A computed tomographic abdominal scan revealed a retroperitoneal solid mass. Surgical exploration performed later displayed solid and well delimited mass throughout retroperitoneal space followed by excision of lesion and multiple drainages. Microscopic pathological examination was benign nerve sheath tumor. Conclusion. These tumors are characteristically firm, smooth, and asymptomatic. They range in size from 1-2 mm to over 20 cm. Awareness of this indolent and rare condition is an important prerequisite for early diagnosis and appropriate treatment. Surgical excision can usually be accomplished by enucleating of the tumor without damage to the adjacent nerve.

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Possible toxicity following embolization of congenital giant vertex hemangioma: case report

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.5.peds13345 ◽

2017 ◽

Vol 19 (3) ◽

pp. 296-299 ◽

Cited By ~ 4

Author(s):

Ingrid Kieran ◽

Zaitun Zakaria ◽

Chandrasekaran Kaliaperumal ◽

Declan O'Rourke ◽

Alan O'Hare ◽

...

Keyword(s):

Surgical Excision ◽

Vascular Tumor ◽

Percutaneous Injection ◽

Ethylene Vinyl Alcohol ◽

First Case ◽

Immune Mediated ◽

Embolic Agents ◽

History Of ◽

Embolization Procedure ◽

Toxic Reactions

The authors describe the case of a 3-year-old boy with a giant congenital vertex hemangioma who underwent presurgical embolization with Onyx (ethylene-vinyl alcohol copolymer dissolved in dimethyl sulfoxide) and Glubran (N-butyl-2-cyanoacrylate). This vascular tumor had no intracranial vascular communication as assessed by pre-embolization MRI and catheter angiography. All embolizations were performed by direct percutaneous injection. One week following the last embolization procedure the child presented with a 24-hour history of ataxia and extrapyramidal tremor. He was diagnosed with a possible immune-mediated reaction to Onyx or Glubran, which was treated with an urgent surgical excision of the hemangioma followed by intravenous administration of immunoglobulin and steroids. To the authors' knowledge, this is the first case of possible immune-mediated toxicity secondary to either Onyx or Glubran administration. This case highlights the need for awareness of potential toxic reactions to these embolic agents in the treatment of hemangiomas in the pediatric patient.

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Intracranial subdural osteoma

European Journal of Inflammation ◽

10.1177/2058739220926854 ◽

2020 ◽

Vol 18 ◽

pp. 205873922092685

Author(s):

Yunna Yang ◽

Zheng Gu ◽

Yinglun Song

Keyword(s):

Dura Mater ◽

Histopathological Examination ◽

Surgical Excision ◽

Benign Neoplasms ◽

Resonance Imaging ◽

Inner Surface ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

T1 Hyperintensity ◽

The Right

Subdural osteomas are extremely rare benign neoplasms. Here, we report the case of a 35-year-old female patient with a right frontal and parietal subdural osteoma. The patient presented with a 2-year history of intermittent headache and fatigue. Computerized tomography (CT) scan showed a high-density lesion attached to the inner surface of the right frontal and parietal skull. Magnetic resonance imaging (MRI) demonstrated T1 hyperintensity and T2 hypointensity of the lesion. Intraoperatively, the hard mass was located in subdural space and attached to the dura mater. Histopathological examination revealed lamellated bony trabeculae lined by osteoblasts and the intertrabecular marrow spaces occupied by adipose tissue. The patient underwent neurosurgical resection and recovered without complication. Surgical excision is recommended to extract the symptomatic lesions with overlying dura mater.

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SURGICAL MANAGEMENT OF PAINFUL OS SUBFIBULARE: A CASE REPORT

Journal of Musculoskeletal Research ◽

10.1142/s0218957720720021 ◽

2020 ◽

Vol 23 (01) ◽

pp. 2072002

Author(s):

Kunal A. Shah ◽

Ajay C. Shah

Keyword(s):

Ligament Reconstruction ◽

Ankle Instability ◽

Previous History ◽

Rare Condition ◽

Surgical Excision ◽

Ossification Center ◽

Anterior Talofibular Ligament ◽

Ankle Pain ◽

Avulsion Fractures ◽

History Of

Separated ossicle at the tip of lateral malleolus, a rare condition called os subfibulare, sometimes is a cause of ankle pain. There are two theories regarding the origin of os subfibulare. One theory proposes that it is caused by an avulsion fracture attributable to pull of the anterior talofibular ligament, whereas the other theory proposes that it is the result of an accessory ossification center. Accessory bones may be stable or may sustain injuries and become avulsed. Most cases have described the surgical treatment of avulsion fractures with excision of the fragment and anterior talofibular ligament reconstruction. We describe a rare case of a symptomatic Os subfibulare caused by an accessory ossification center in a 27-year-old female with no previous history of trauma. Surgical excision was done without ligament reconstruction and the symptoms resolved completely after the surgery and there was no residual ankle instability.

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