Presentation and Management Outcome of Glomus Tumors of the Hand

Document Type : RESEARCH PAPER


Department of Plastic Surgery, NIRM, Islamabad, Pakistan


Background: To document the clinical presentation of glomus tumors of the hand and evaluate the outcome of
complete surgical excision in terms of relief of symptoms, any postoperative nail deformities and tumor recurrence over
a period of one year.
Methods: This descriptive case series spanned over a period of twelve years. All patients of either gender and all ages
who had histologically confirmed glomus tumors of the hands were included. All of them underwent surgical excision
under local anesthesia.
Results: Out of 17 patients, majority (n=12; 70.58%) were females. The mean age was 41.17±13.7 years. The
dominant hand was involved in 11 (64.70%) patients. There were 14 patients (82.35%) with subungual tumors whereas
3(17.64%) had volar pulp glomus tumors. The mean diagnostic delay was 18.88±9.3 months. The tumor size ranged
from 2 mm to 1.1cm with a mean of 4.05±4.3mm. All the patients (n=17,100%) experienced complete symptomatic
relief within 2-4 weeks after surgical excision. There were no postoperative nail deformities. There was no recurrence
over a period of one year.
Conclusion: Glomus tumors of the hands were more frequently found among women in their fourth and fifth decades.
Dominant hand, index finger and distal phalanx represented the commonest affected anatomic locales. Majority of the
tumors were subungual. Majority of the patients suffered over 12 months in distressful pain before being diagnosed.
Complete surgical excision under local anesthesia provided rapid relief of the symptoms. Creation of awareness about
the tumor among doctors as well as public would help to ensure early presentation to plastic surgeon, prompt diagnosis
and hence avoidance of the prolonged periods of agonizing misery.
Level of evidence: III


1. Samaniego E, Crespo A, Sanz A. Key diagnostic
features and treatment of subungual glomus tumor.
Actas Dermo-Sifiliográficas (English Edition). 2009;
2. Tang CY, Tipoe T, Fung B. Where is the lesion? Glomus
tumours of the hand. Archives of plastic surgery.
2013; 40(5):492.
3. Morey VM, Garg B, Kotwal PP. Glomus tumours of
the hand: review of literature. Journal of clinical
orthopaedics and trauma. 2016; 7(4):286-91.
4. Netscher DT, Aburto J, Koepplinger M. Subungual
glomus tumor. Journal of Hand Surgery. 2012;
5. Anakwe RE, McEachan JE. A glomus tumour
beneath the painful unpolished nail. Cmaj. 2010;
6. Santoshi JA, Kori VK, Khurana U. Glomus tumor of the 
fingertips: A frequently missed diagnosis. Journal of
Family Medicine and Primary Care. 2019; 8(3):904.
7. Montandon C, Costa JD, Dias LA, Costa FH, Costa AC,
Daher RT, et al. Subungual glomus tumors: imaging
findings. Radiologia Brasileira. 2009; 42(6):371-4.
8. Ham KW, Yun IS, Tark KC. Glomus tumors: symptom
variations and magnetic resonance imaging for
diagnosis. Archives of plastic surgery. 2013;
9. Fazwi R, Chandran PA, Ahmad TS. Glomus tumour:
a retrospective review of 15 years’ experience in a
single institution. Malaysian orthopaedic journal.
2011; 5(3):8.
10. Bargon CA, Mohamadi A, Talaei-Khoei M, Ring DC,
Mudgal CS. Factors Associated with Requesting
Magnetic Resonance Imaging during the Management
of Glomus Tumors. Archives of Bone and Joint Surgery 
2019; 7(5):422.
11. Pandey CR, Singh N, Tamang B. Subungual glomus
tumours: is magnetic resonance imaging or ultrasound
necessary for diagnosis? Malaysian Orthopaedic
Journal. 2017; 11(1):47.
12. Mravic M, LaChaud G, Nguyen A, Scott MA, Dry SM,
James AW. Clinical and histopathological diagnosis
of glomus tumor: an institutional experience of 138
cases. International journal of surgical pathology.
2015; 23(3):181-8.
13. Fujioka H, Kokubu T, Akisue T, Nanura I, Toyokawa N,
Inul A, et al. Treatment of subungual glomus tumor.
Kobe J Med Sci. 2009; 55(1): E1-E4.
14. Jawalkar H, Maryada VR, Brahmajoshyula V, Kotha
GK. Subungual glomus tumors of the hand: Treated by
transungual excision. Indian journal of orthopaedics.
2015; 49(4):403.
15. Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Subhi
F, El-Shayeb AF. Magnetic resonance imaging in the
diagnosis of glomus tumours of the hand. Journal of
Hand Surgery. 2005; 30(5):535-40.
16. Lee W, Kwon SB, Cho SH, Eo SR, Kwon C. Glomus
tumor of the hand. Archives of plastic surgery. 2015;
17. Shin DK, Kim MS, Kim SW, Kim SH. A painful glomus
tumor on the pulp of the distal phalanx. Journal of
Korean Neurosurgical Society. 2010; 48(2):185.
Recurrent digital glomus tumor: analysis of 75 cases.
Dermatologic surgery. 2010; 36(9):1396-400.
19. Dwidmuthe S, Nemade A, Rai S. Glomus tumor of
thumb occurring at unusual location. Journal of
Surgical Technique and Case Report. 2013; 5(2):92-4.
20. Senhaji G, Gallouj S, El Jouari O, Lamouaffaq A,
Rimani M, Mernissi FZ. Rare tumor in unusual
location–glomus tumor of the finger pulp (clinical
and dermoscopic features): a case report. Journal of
medical case reports. 2018; 12(1):196.
21. Rosner IA, Argenta AE, Washington KM. Unusual
volar pulp location of glomus tumor. Plastic and
Reconstructive Surgery Global Open. 2017; 5(1).
22. Shugart RR. Glomus tumor. Surg Gynecol Obstet...
1963; 117:334-40.
23. Carroll RE, Berman AT. Glomus tumors of the hand:
review of the literature and report on twenty-eight
cases. JBJS. 1972; 54(4):691-703.
24. Rettig AC, Strickland JW. Glomus tumor of the digits.
The Journal of Hand Surgery. 1977; 2(4):261-5.
25. Beasley SW, Mel J, Chow CW, Jones PG. Hereditary
multiple glomus tumours. Archives of disease in
childhood. 1986; 61(8):801-2.
26. Song M, KO HC, KWON KS, Kim MB. Surgical treatment
of subungual glomus tumor: a unique and simple
method. Dermatologic surgery. 2009; 35(5):786-91.
27. Muramatsu K, Ihara K, Hashimoto T, Tominaga Y,
Taguchi T. Subungual glomus tumours: Diagnosis and
microsurgical excision through a lateral subperiosteal
approach. Journal of Plastic, Reconstructive &
Aesthetic Surgery. 2014; 67(3):373-6.
28. Macharia C, Nthumba PM. Glomus tumor presenting
as complex regional pain syndrome of the left upper
limb: a case report. Journal of medical case reports.
2015; 9(1):1-4.
29. Koç O, Kivrak AS, Paksoy Y. Subungual glomus tumour:
magnetic resonance imaging findings. Australasian
radiology. 2007; 51:B107-9.
30. Vasisht B, Watson HK, Joseph E, Lionelli GT. Digital
glomus tumors: a 29-year experience with a lateral
subperiosteal approach. Plastic and reconstructive
surgery. 2004; 114(6):1486-9.
31. Tada H, Hirayma T, Takemitsu Y. Prevention of
postoperative nail deformity after subungual glomus
resection. Journal of Hand Surgery. 1994; 19(3):500-3.
32. Takata H, Ikuta Y, Ishida O, Kimori K. Treatment of
subungual glomus tumour. Hand Surgery. 2001;
33. Grover C, Khurana A, Jain R, Rathi V. Transungual
surgical excision of subungual glomus tumour. Journal
of cutaneous and aesthetic surgery. 2013; 6(4):196.
34. Rahbari K, Farzan M, Saffar H, Farhoud AR. Glomus
Tumor of Uncertain Malignant Potential in Thumb:
A Case Report and Review of Literature. Archives of
Bone and Joint Surgery. 2020; 8(1):117. 
Volume 9, Issue 3
May 2021
Pages 312-318
  • Receive Date: 14 April 2020
  • Revise Date: 16 July 2020
  • Accept Date: 11 August 2020
  • First Publish Date: 01 May 2021