A modified periungual approach for treatment of subungual glomus tumour.

Subungal glomus tumours are uncommon; the only treatment is complete surgical excision. Transungual approach is often preferred; however, secondary nail deformity may occur. Lateral periungual approach is used to avoid this complication, but this approach provides limited exposure and is used for peripheral lesion only. We describe a modified periungual approach which can be applied to central lesions. This approach can provide adequate exposure for complete excision of the subungual tumour while avoiding incision of the nail bed.     

Atypical presentation of a glomus tumour: A case report

A 46-year-old man presented with an extremely painful, 1 cm, mobile, nodular mass located on the medial side of his right elbow. Symptoms failed to respond to conservative treatment. Ultrasound and Doppler flow imaging revealed a well-defined, round hypoechoic mass. Under local anesthesia, the mass was resected and the wound closed without complication. Final pathology diagnosed the lesion as a glomus tumour, solid type. Histology staining showed the tumour cells were positive for antibodies to vimentin and muscle actin. It is unusual for a glomus tumour to be located anterior to the medial epicondyle of the right arm. Hand surgeons most commonly encounter glomus tumours in the nailbeds of the fingers.     

Atypical adenolymphoma and glomus caroticum tumour: a rare coincidence

We describe the rare simultaneous appearance of an atypical adenolymphoma with a glomus caroticum tumour on the same side of the neck in a middle-aged man. This case report is the first to describe this coexistence. Due to the atypical, cyst-like presentation of the Warthin's tumour, a final diagnosis was made only after surgical resection and histopathological examination. Both the adenolymphoma and glomus caroticum tumour were successfully removed surgically.     

Synchronous subungual glomus tumours in adjacent digits.

In the hand, glomus tumours usually present as a single lesion comprising one or more discrete masses affecting the subungual area of one digit. We report a case in which typical glomus tumours occurred simultaneously in the subungual area of two adjacent digits.     

Intra-osseous glomus tumour: a case report.

A rare case of intra-osseous glomus tumour is described, together with a review of eight other reported cases. Electron microscopic studies suggest that glomus cells, the histogenesis of which has not been completely resolved, originate from smooth muscle. Studies in this case support that hypothesis: they showed the important role of contraction of the glomus cells in eliciting the peculiar type of pain.     

甲外血管球瘤诊断与治疗的相关因素分析

目的 分析甲外血管球瘤诊断与治疗的相关因素.方法 对2005年1月至2009年12月手术治疗的22例甲外血管球瘤进行回顾性分析.22例中,男女比例为1∶1.75(8∶14),年龄为24～63岁(平均39.4岁),发病至手术时间为3个月至28年(平均84.8个月).血管球瘤位于指腹17例(占77.3%,17/22),指近节掌侧2例(占9.1%,2/22),手掌2例(占9.1%,2/22),内踝1例(占4.5%,1/22).其中多发瘤2例(占9.1%,2/22),外伤史2例(占9.1%,2/22),可及肿物9例(占40.9%,9/22),Love试验阳性22例(占100%,22/22),冷敏感试验阳性7例(占31.8%,7/22).临床误诊12例(占54.5%,12/22),B超发现率22例(占100%,22/22).血管球瘤平均直径为4.1 mm(2.0～7.0 mm).结果 22例术后随访时间为4～144个月,其中19例(占87.4%,19/22)术后痊愈,自发痛及触痛消失.肿瘤复发3例(占13.6%,3/22),再次术后未见复发.结论 甲外血管球瘤缺乏典型的症状体征,诊断困难,提高对血管球瘤的认识,运用Love试验及高频B超,可有效地避免误、漏诊.完整切除肿瘤可以获得明确的疗效.

Abstract：

Objective To analyze the related factors of the diagnosis and treatment of extraungual glomus tumors. Methods A retrospective analysis of 22 cases of extraungual glomus tumor treated from January 2005 to December 2009 were conducted. There were 8 male patients and 14 female patients with a malewas 84.8 months (range, 3 months to 28 years). The glomus tumors were located in the pulp in 17 cases (77.3%, 17/22), on the palmar side of the proximal finger in 2 cases (9.1%, 2/22), on the palm of the hand in2 cases (9.1%, 2/22), and at the medial malleolus in 1 case (4.5%, 1/22). There were 2 cases (9.1%,2/22) with multiple tumors, 2 cases (9.1%,2/22) with previous injury, and9 cases (40.9%,9/22)with palpable tumors. All ( 100% ,22/22) cases had positive Love test, while cold-intolerance test was positive in 7 cases (31.8% ,7/22). The clinical misdiagnosis rate was 54.5% (12/22). Ultrasonographic diagnosis was correct in all 22 cases ( 100%, 22/22). The average diameter of the tumor was 4.1 mm (range, 2.0 to 7.0mm). Results Postoperative follow-up period ranged from 4 months to 144 months. Cure was observed in 19 cases in which spontaneous pain and tenderness disappeared. Local recurrence occurred in 3 (13.6%)patients. No recurrence was observed after the second surgical excision. Conclusion Extraungual glomus tumors are difficult to diagnose due to the lack of specific symptoms and physical signs. A better understanding of the tumor, Love test and ultrasound examination are effective methods for reducing the rate of misdiagnosis.Complete excision of the tumor is an effective treatment method.     

32例甲外血管球瘤的临床分析

目的 总结甲外血管球瘤的临床特点及诊治方法 .方法 2000年1月至2008年4月对32例甲外血管球瘤进行诊治,其中30例单发,2例为两处病灶.均行局部病灶切除术.结果 术后随访2～98个月,平均46个月.所有患者术前症状全部消失,无复发病例.结论 甲外血管球瘤具有特征性的临床表现,即疼痛、压痛、冷激惹的三联征,因病变隐匿,诊断较困难,肿瘤切除术是唯一有效的治疗方法 .     

32例甲外血管球瘤的临床分析

目的 总结甲外血管球瘤的临床特点及诊治方法 .方法 2000年1月至2008年4月对32例甲外血管球瘤进行诊治,其中30例单发,2例为两处病灶.均行局部病灶切除术.结果 术后随访2～98个月,平均46个月.所有患者术前症状全部消失,无复发病例.结论 甲外血管球瘤具有特征性的临床表现,即疼痛、压痛、冷激惹的三联征,因病变隐匿,诊断较困难,肿瘤切除术是唯一有效的治疗方法 .     

32例甲外血管球瘤的临床分析

目的 总结甲外血管球瘤的临床特点及诊治方法 .方法 2000年1月至2008年4月对32例甲外血管球瘤进行诊治,其中30例单发,2例为两处病灶.均行局部病灶切除术.结果 术后随访2～98个月,平均46个月.所有患者术前症状全部消失,无复发病例.结论 甲外血管球瘤具有特征性的临床表现,即疼痛、压痛、冷激惹的三联征,因病变隐匿,诊断较困难,肿瘤切除术是唯一有效的治疗方法 .     

A glomus tumour with four recurrences

A case of a glomus tumour of the distal segment of the ring finger, with four apparent recurrences in an 8-year period, is described. The patient was treated by two different surgeons (two and three times respectively) and obtained pain free intervals of between 4 and 11 months before recurrence. Histological examination confirmed the diagnosis of a glomus tumour in all five procedures. The location of the glomus tumour was defined preoperatively by high resolution MR imaging.