From the Guidelines
Glomus tumor of the fingernail is a rare, benign neoplasm that arises from the glomus body, a specialized arteriovenous structure, characterized by localized tenderness, severe paroxysmal pain, and sensitivity to cold.
Diagnosis and Treatment
- The diagnosis of glomus tumor is typically based on clinical presentation and imaging studies, although the provided evidence does not specifically discuss diagnostic methods for glomus tumors of the fingernail 1.
- Surgical excision is the treatment of choice for glomus tumors of the fingernail, as it allows for complete removal of the tumor and histological examination of the tissue 1.
- The procedure typically involves a nail plate avulsion, followed by a thorough exploration of the nail bed to locate and remove the tumor.
- Pre-operatively, a course of analgesics such as acetaminophen 650mg every 4-6 hours or ibuprofen 400mg every 4-6 hours may be prescribed to manage pain.
- Post-operatively, patients are advised to keep the affected finger elevated and apply ice packs to minimize swelling.
- A topical antibiotic ointment such as bacitracin or neomycin may be applied to the wound to prevent infection.
- Pain management post-operatively may include acetaminophen 650mg every 4-6 hours or ibuprofen 400mg every 4-6 hours as needed.
- It is essential to note that recurrence of the tumor is possible, and patients should be monitored closely for any signs of recurrence, such as persistent or recurrent pain, or changes in the appearance of the nail or nail bed 1.
From the Research
Diagnosis of Glomus Tumor
- The diagnosis of glomus tumor is based on a combination of clinical presentation, imaging studies, and histopathologic examination 2.
- The classic triad of symptoms includes localized tenderness, severe pain, and cold sensitivity 3, 2.
- Imaging studies such as magnetic resonance imaging (MRI), ultrasonography, and radiography can aid in the diagnosis 3, 4.
- A high index of suspicion is required for early diagnosis and management of glomus tumors 2.
Treatment of Glomus Tumor
- Complete surgical excision is the curative treatment for glomus tumor 5, 3, 2, 4, 6.
- The transungual approach with complete excision of the nail plate has been shown to reduce the risk of recurrence and post-operative nail deformity 5, 6.
- Surgical excision can be performed in local anesthesia and a bloodless field, with good cosmetic results 4, 6.
- The treatment can significantly improve the quality of life of patients by relieving pain and improving nail-related symptoms 6.
Characteristics of Glomus Tumor
- Glomus tumors are rare, benign, and slow-growing tumors that arise from neuromuscular-arterial structures called glomus bodies 5, 3, 2.
- They are commonly found in the subungual region of the fingers, particularly in young females 5, 3.
- The tumors can cause significant pain and impairment of quality of life, with a mean delay in diagnosis of around 7 years 2.