Background: A rare benign tumour of the hand, the glomus tumour, accounts for about 1% to 4.5% of tumours of the hand. This tumour has its origin in the neuroarterial structure known as the glomus body. These tumours usually present as painful lesions in the fingertips in the 2nd to 5th decade of life, more commonly in females of younger age groups. Magnetic resonance imaging (MRI) plays an important role in its diagnosis. Tumour excision using a transungual approach yields excellent long-term patient outcomes.
Case report: A 54 years old female with no medical comorbidities, presented to our OPD with severe intensity pain in two non-adjacent fingertips of the right hand (2nd and 4th) for 1 year. The onset of the pain was sudden, was progressive, aggravated by pressure on the nails and was partly relieved by oral analgesics. On examination, the fingertips were tender on touch and the pinprick test (Loves test) over the respective nail beds was positive. MRI was done which was suggestive of a glomus tumour in the 2nd and 4th fingertips. Tumour excision was done using a transungual approach under local anaesthesia as an OPD procedure. The biopsy of the tumour was consistent with the glomus tumour. On follow up, the patient is completely relieved of the symptoms.
Conclusion: Glomus tumour, a rare benign tumour of fingertips should be considered in the differential diagnosis of fingertip pain syndromes. A thorough history and clinical examination in combination with MRI is an excellent method of arriving at the correct diagnosis. Excision through a transungual approach under local anaesthesia yields excellent long-term patient outcomes.
Key words: Glomus tumor, Nail bed, Magnetic resonance imaging
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