Glomus Tumor of Left Little Finger: A Case Report

Case Diagnosis: 53 year old female with past medical history of tobacco use disorder, hyperlipidemia, hypertension presented to clinic with complaints of left fifth digit pain.

Case Description or Program Description: 53 year old female with past medical history of tobacco use disorder, hyperlipidemia, hypertension presented to clinic with complaints of left fifth digit pain. At the time, she had reported pain for 3 months located on the distal tip of the left digit that worsened with temperature changes. She reported paroxysmal extreme pain with color changes to white. These symptoms did not affect any other digit, and therefore it was elected to obtain an MRI at one year follow up. MRI revealed a 2mm round nodule of within the subcutaneous tissues of the volar tip of the fifth digit. Suspicion for glomus tumor of the left 5th digit was established and patient was referred to orthopedic surgery for excision. Excision was performed and surgical pathology confirmed diagnosis of glomus tumor.

Setting: Tertiary Adult MSK clinic

Assessment/Results: She was seen one month post-op and reported improved symptoms with mild incisional pain.

Discussion (relevance): Glomus tumors are uncommon vascular lesions that are benign [1]. They are typically found in the subungual regions and present as severe episodic pain, hypersensitivity to temperature and local tenderness [1]. The occurrence of glomus tumors does not have any defined risk factors, however can be found more frequently in females in the fourth or fifth decade of life [2]. Upon identification of a suspected glomus tumor lesion, MRI should be obtained to evaluate as this has a positive predictive value of 97% [1]. If imaging correlates to clinical suspicion, excision should be performed for adequate relief of symptoms [2]. Upon excision, pathology should be obtained for definitive diagnosis.

Conclusions: Glomus tumors can be difficult to diagnose and cause long periods of severe pain if not timely evaluated and excised. Based on one study correlation exists with gender and age, however after careful clinical evaluation diagnoses should be further established with MRI and surgical biopsy.