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What is a Glomus Tumor?

Glomus Tumors, also known as paragangliomas, are growths that are most often found in the nail bed under the fingernails. They can also exist in finger pads as well as on the palm, wrist, and forearm. Glomus tumors normally appear as small dark red or blue lesions underneath fingernails and can cause cold-sensitivity, tenderness and, occasionally, burning pain in the affected area.

Although benign, glomus tumors are typically surgically removed. They generally amount for less than 2% of all soft tissue tumors.

Characteristics and Clinical Presentation of a Glomus Tumor

A glomus tumor is typically a solitary lesion. They are found within the distal extremities, especially the hand or wrist, though usually under the fingernails. They are often painful.

Pain from glomus tumors often presents when the affected region is placed under cold water or other cold environments. They tend to have a blue discoloration. They may elevate the nail bed or deform the nail.

Symptoms include:

  • Paroxysmal pain
  • Tenderness to touch
  • Cold intolerance

Getting a Diagnosis for Glomus Tumors

A physical examination is necessary to locate bluish nodules in the subungual location, often presenting with nail ridging and discoloration. Pressure applied to the area with typically results in pain. Imaging tests such as X-rays are helpful in visualizing the extent of erosion to the underlying bone if any, as well as seeking alternative causes for pain.

However, an MRI with gadolinium is the most helpful in reaching a definitive diagnosis.

Treatment Options for Glomus Tumors

A glomus tumor is typically treated with surgical intervention. Because this condition can affect the patient’s quality of life, a definitive diagnosis is necessary to evaluate the extent of the condition.

However, because this condition is benign, recurrence is uncommon. Multiple growths in the area may occur. Repair of the nail bed may be necessary following surgical removal of glomus tumors.

Conservative Treatments

Glomus Tumors are painful and can have a marked effect on the patient’s quality of life. Your surgeon may advocate monitoring the tumor closely for changes, during which time you will need periodic follow-ups for X-rays and possibly other imaging.

However, surgical intervention is often required. You should always seek the supervision of a specialized hand surgeon to aid in the definitive diagnosis and optimal prognosis of a glomus tumor.

Surgical Treatments

Surgical intervention is often curative for Glomus Tumors, but recurrence or another glomus nearby may appear. This procedure is done with regional block anesthesia and is considered outpatient. The nail bed is sometimes removed when needed, depending on tumor location, and an incision is made to expose the tumor. The tumor is removed and the site closed before the nail is replaced.

Pain and intolerance to cold are generally relieved following the surgery.

Preventing Glomus Tumors

Glomus tumors are unpredictable. Because of this, they are unpreventable and sometimes confusing detection. For this reason, patients are advised to receive regular physical examinations and follow-ups for pain in the finger, hand, and wrist area, particularly lesions that may be cold-sensitive. If you have questions or concerns about a growth on your hand, you should schedule a visit to Drs. Pruzansky soon.

Prognosis for Glomus Tumors

The nail is expected to regrow within 3-4 months. Removal of the tumor often has curative results, with few relapses of solitary lesions. Malignant glomus tumors are very rare. Patients can typically look forward to a full recovery after the initial healing period. Remodeling may take a year.

If You Believe You Have a Glomus Tumor, Contact HandSport Surgery Institute.

Please contact us to schedule an appointment with our talented team. People who have pain should be evaluated to try and prevent further damage and discomfort.

If you have hand pain it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.

 

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