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

Hand ◽  
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.

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

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Sang Ki Lee ◽  
Dae Geon Song ◽  
Won Sik Choy
Keyword(s):  
Chronic Pain ◽  
Glomus Tumor ◽  
Rare Condition ◽  
Surgical Excision ◽  
Vascular Tumor ◽  
Glomus Tumors ◽  
Contrast Magnetic Resonance ◽  
History Of ◽  
Subcutaneous Layer ◽  
Magnetic Resonance Imaging Mri

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.

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

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.

Dorsal root ganglion stimulation lead fractures: potential mechanisms and ways to avoid

2021 ◽  
Vol 14 (5) ◽  
pp. e241353
Author(s):  
Gaurav Chauhan ◽  
Brandon I Roth ◽  
Nagy Mekhail
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Case Report ◽  
Dorsal Root Ganglion ◽  
Dorsal Root ◽  
Unusual Case ◽  
Pain Syndrome ◽  
Structural Instability ◽  
Probable Mechanism ◽  
Lead Fracture

Dorsal root ganglion stimulation (DRGS) therapy is a rapidly emerging tool being used by pain physicians in the treatment of chronic pain. Complex regional pain syndrome (CRPS), a debilitating disease whose mechanism is still has yet to be fully elucidated, is a common pathology targeted by DRGS therapy, often better results than traditional spinal cord stimulation. DRGS therapy, however, is not bereft of complications. Lead migration and fracture are two examples in particular that are among the most common of these complications. The authors report an unusual case of lost efficacy due to lead fractures in patients with CRPS treated with DRGS. The case report narrates identification, management and probable mechanism of DRGS lead fracture. The structural instability of DRGS leads can yield distressing symptoms at any point during the therapy, and physicians should be cognisant of the complications of DRGS therapy.

Short-Scar Surgical Approach for the Treatment of Glomus Tumor of the Digit

2011 ◽  
Vol 15 (1) ◽  
pp. 21-28
Author(s):  
Emanuele Cigna ◽  
Francesca Palumbo ◽  
Liliana De Santo ◽  
Andrea Edoardo Zampieri ◽  
Giuseppe Soda
Keyword(s):  
Surgical Approach ◽  
Glomus Tumor ◽  
Benign Neoplasm ◽  
Surgical Excision ◽  
Radical Resection ◽  
Surgical Approaches ◽  
Complete Regression ◽  
Recurrence Rates ◽  
Glomus Tumors ◽  
Short Scar

Background: A glomus tumor is a biologically benign neoplasm. The traditional surgical approach to treat this tumor boasts the lowest recurrence rates but may cause nail deformities. Objective: A short-scar surgical approach was applied, with the aim of preserving the aesthetics of the nail. Methods: Between January 1999 and January 2009, 25 patients who underwent surgery for a glomus tumor were included in the study. All patients underwent radical resection with three different surgical approaches based on the location of the tumor. Results: All patients who were operated on had complete regression of pain immediately after surgery and at postsurgery follow-ups. Conclusion: The treatment of glomus tumors consists of surgical excision, which is successful if properly executed. Excision of sensitive afferent nervous fibers is a prerequisite to achieve regression of pain. A short-scar surgical approach ensures complete eradication of the tumor and preservation of nail aesthetics.

Glomus Tumor on the Volar Aspect of the Distal Phalanx, an Unusual Presentation for an Unusual Neoplasm‎: A Case Report

2020 ◽  
Author(s):  
Sam Hajialiloo-Sami ◽  
Amir Mohsen Khorrami ◽  
Sajad Noori
Keyword(s):  
Glomus Tumor ◽  
Ring Finger ◽  
Surgical Excision ◽  
Distal Phalanx ◽  
Cold Sensitivity ◽  
Diagnostic Features ◽  
Glomus Tumors ◽  
Delay In Diagnosis ◽  
Volar Aspect ◽  
Histologic Evaluation

Background: In the fingertips, the glomus tumors usually involve the subungual areas with typical triad symptoms including pain, tenderness to palpation, and cold sensitivity. The glomus tumor of volar aspect of digits is rare.   Case Presentation: A case of glomus tumor was presented at the volar side of the distal phalanx of the ring finger of a 52-year-old woman. The tumor was painful and tender to palpation, yet insensitive to cold. The atypical location and insensitivity to cold led to a 4-year delay in diagnosis. After the surgical excision of the lesion, the extracted mass was sent for histologic evaluation and the diagnosis of glomus tumor was confirmed. One-year follow-up of the patient was event-free.   Conclusions: Atypical glomus tumor should be considered in the differential diagnosis of finger pain, even in the absence of characteristic diagnostic features.

Lower Extremity Glomus Tumors: Comprehensive Review for Surgeons

Vascular ◽  
2008 ◽  
Vol 16 (6) ◽  
pp. 326-332 ◽  
Author(s):  
Leon R. Luis ◽  
Goshima R. Kaoru ◽  
Psalms B. Shemuel ◽  
Joseph L. Mills
Keyword(s):  
Lower Extremity ◽  
Glomus Tumor ◽  
Symptomatic Relief ◽  
Delayed Diagnosis ◽  
Surgical Excision ◽  
Disease Entity ◽  
Review Of The Literature ◽  
Comprehensive Review ◽  
Glomus Tumors ◽  
Diagnosis And Management

The diagnosis of a lower extremity glomus tumor (GT) is often delayed owing to the lack of awareness and low level of suspicion by the treating physician. GT is thought to arise from cutaneous arteriovenous connections, often involving the nail beds. The unusual location of the lower extremity often leads to missed or delayed diagnosis and management. Surgical excision of GT is often curative and provides significant symptomatic relief. There is a paucity of information in regard to GT in general, especially among vascular surgeons. The aim of this report is to make the surgical community more aware of this disease entity based on the analysis of our own experience and review of the literature.

scholarly journals Successful and unsuccessful recruitment and retainment strategies in a UK multicentre drug trial for a rare chronic pain condition which performed above target

2019 ◽  
Vol 14 (3) ◽  
pp. 171-179
Author(s):  
Jatinder Bisla ◽  
Gareth Ambler ◽  
Bernhard Frank ◽  
Sumit Gulati ◽  
Poppy Hocken ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Clinical Trials ◽  
Pain Syndrome ◽  
Chronic Pain Patient ◽  
Recruitment Rate ◽  
Pain Patient ◽  
Trial Management ◽  
Old Patients ◽  
Chronic Pain Condition ◽  
Pain Condition

Introduction: Recruitment into trials in rare chronic pain conditions can be challenging, so such trials consequently are underpowered or fail. Methods: Drawing from our experience in conducting, to date, the largest academic trial in a rare chronic pain condition, complex regional pain syndrome, we have identified recruitment and retention strategies for successful trial conduct. Results: We present 13 strategies grouped across the categories of ‘setting the recruitment rate’, ‘networking’, ‘patient information’, ‘trial management’ and ‘patient retention’. Moreover, six recruitment risks are also discussed. A conservative recruitment estimate, based on audits of newly referred patients to the trial centres without taking into account availability of ‘old’ patients or recruitment from outside centres, and assuming a 55% patient refusal rate yielded accurate numbers. Conclusion: Appreciation of these identified recruitment challenges and opportunities may contribute to supporting prospective investigators when they design clinical trials for chronic pain patient population groups where it has been historically difficult to conduct high-quality and robust clinical trials.

Abstract 326: Postural Orthostatic Tachycardia Syndrome and its Associated Chronic Pain Symptoms

2015 ◽  
Vol 117 (suppl_1) ◽  
Author(s):  
Chandralekha Ashangari ◽  
Amer Suleman
Keyword(s):  
Chronic Pain ◽  
Medical Records ◽  
Chronic Back Pain ◽  
Pain Syndrome ◽  
The Body ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Chronic Regional Pain Syndrome ◽  
High Prevalence ◽  
Pain Symptoms ◽  
Very High

Background and Purpose: The Postural Orthostatic Tachycardia Syndrome (POTS) affects primarily young women. POTS is a form of dysautonomia that is estimated to impact between 1,000,000 and 3,000,000 Americans, and millions more around the world. The symptoms of POTS are widespread because the autonomic nervous system plays an extensive role in regulating functions throughout the body. The aim of this study is to determine the chronic pain symptoms in Postural Orthostatic tachycardia syndrome (POTS) patients. Method: Two hundred fifty-five (255) POTS patients were randomly selected from our clinic (January 2014 to March 2015) , reviewed the medical records of 255 POTS patients for chronic pain symptoms and performed data analysis. Results: Two hundred thirty-three of the 255 (91%) patients are females (n=233, age 29.20 ± 10.32), Twenty-three of the 255 (9%) patients are males (n=23, age 29.70 ± 14.52).63% (161 of the 255) had Joint Pain/aches, 51% (131 of the 255) had Chronic headache, 40% (102 of the 255) had chest pain, 31% (80 of the 255) had Migraine, 30% (76 of the 255) had Chronic back pain,16% (42 of the 255) had Heartburn,8%(20 of the 255) had Chronic pleurisy, Rheumatoid arthritis, Muscle aches, Chronic regional pain syndrome and Hip aches. Conclusion: Our study is the first to characterize that Patients with postural orthostatic tachycardia syndrome (POTS) have a very high prevalence of chronic pain symptoms.

scholarly journals Unusual Glomus Tumor of the Penis

2015 ◽  
Vol 9 (3) ◽  
pp. 113-118 ◽  
Author(s):  
Gautam Dagur ◽  
Kelly Warren ◽  
Yimei Miao ◽  
Navjot Singh ◽  
Yiji Suh ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Spindle Cell ◽  
Glomus Tumor ◽  
Treatment Options ◽  
Surgical Excision ◽  
Primary Objective ◽  
Inclusion Criteria ◽  
Glomus Tumors ◽  
Clinical Presentations ◽  
Epithelial Lesions

Introduction: Glomus tumors are benign neoplasms commonly found in subungual regions of the extremities and rarely located in the penis. Misdiagnosis of glomus tumors is common; therefore, symptoms and clinical presentations should be reviewed. Objective: The primary objective of this review article is to emphasize the pathogenesis, pathology, clinical presentation, symptoms, diagnosis, and treatment methods of glomus tumors in order to better identify and manage the condition. Materials and Methods: Research was conducted using PubMed/Medline. The inclusion criteria required glomus tumor to be present on the penis. Results: Glomus tumors, which appear as symptomatic or asymptomatic lesions, are attributed to dispersion grouping of neoplastic or non-neoplastic lesions in a particular area. Conclusion: Differential diagnosis of glomus tumors includes hemangiomas, neurofibromatosis, epithelial lesions, and spindle-cell lesions. Physical examination and histological findings should be used for diagnosis. Treatment options can be either conservative or invasive, in which the patient undergoes surgical excision.

Osteoid Osteoma of Distal Phalanx of Middle Finger—A Diagnostic Dilemma

2016 ◽  
Vol 21 (03) ◽  
pp. 395-398 ◽  
Author(s):  
Bharat Durgia ◽  
Anuj Jain ◽  
Shekhar Agarwal
Keyword(s):  
Chronic Pain ◽  
Osteoid Osteoma ◽  
Lower Limb ◽  
Glomus Tumor ◽  
Surgical Excision ◽  
Middle Finger ◽  
Distal Phalanx ◽  
Long Bones ◽  
Diagnostic Dilemma ◽  
Uncommon Case

Osteoid Osteoma is benign bone forming tumor which commonly occurs in long bones of lower limb. Presence of these rare tumors in the distal phalanx of the digits of the hand is considered a rare phenomenon. In hand, they usually present as chronic pain, swelling, nail enlargement and increase in size of digit. Diagnosis is challenging with clinical examination and usual imaging modalities and often confused with glomus tumor, enchondroma, infection, trauma and rheumatic disease. Surgical excision of the tumor, if present in hand, is the treatment of choice that aids in coming to the exact diagnosis too. The aim of the paper is to report yet another uncommon case of osteoid osteoma of distal phalanx of middle finger mimicking glomus tumor.

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