Glomangioma
Updates to Article Attributes
Glomangiomas,also known as a glomus tumours, are benign vascular tumours typically seen at the distal extremities. These tumours should not be confused with paragangliomas (sometimes referred to as glomus tumour).
Epidemiology
It classically presents in young to middle aged (4th to 5th decades 7). There is a recognised female predilection. They can be multiple in ~ 10% of cases. Glomus tumors account for 1-5% of the soft-tissue tumors in the hand 4.
Clinical presentation
The lesion usually presents as a small firm red-blue nodule under the finger nail and is exquisitely painful. Sometimes the pain is worse at night; it may disappear when a tourniquet is applied.
May also present as haemorrhage under the nail. The presence of the Hildreth sign (pain following the application of a tourniquet proximally) is considered pathognomonic on clinical grounds 7.
Pathology
Glomus tumours originate from the neuromyoarterial plexus: modified smooth muscle cells of the glomus body. They are best thought of as harmatomas rather than true tumours. There are two main components on microscopy:
- branching vascular channels
- aggregates of specialised glomus cells
Location
Approximately 75% occur in the hand 4.
Radiographic features
Conventional radiography
- the tumour is difficult if not impossible to identify - rarely can be seen as a subtle soft tissue density
- may show a marginated osseous erosion or thinning of the adjacent cortical bone
MRI
Signal characteristics include:
- T1: low to intermediate signal
- T1 C+(Gd): shows contrast enhancement (usually uniform) due to vascularity
- T2: high signal
Ultrasound
- subungual hypoechoic lesion at the region of maximum tenderness
- hypervascularity on Doppler interrogation
Treatment and prognosis
Treatment is surgical resection.
Differential diagnosis
General imaging differential considerations include:
See also
- paraganglioma (also sometimes called glomus tumour)
-<p><strong>Glomangiomas</strong>,<strong> </strong>also known as a <strong>glomus tumours</strong>, are benign vascular tumours typically seen at the distal extremities. These tumours should not be confused with <a href="/articles/paraganglioma-1">paragangliomas</a> (sometimes referred to as glomus tumour). </p><h4>Epidemiology</h4><p>It classically presents in young to middle aged (4<sup>th</sup> to 5<sup>th</sup> decades <sup>7</sup>). There is a recognised female predilection. They can be multiple in ~ 10% of cases. Glomus tumors account for 1-5% of the soft-tissue tumors in the hand <sup>4</sup>.</p><h4>Clinical presentation</h4><p>The lesion usually presents as a small firm red-blue nodule under the finger nail and is exquisitely painful. Sometimes the pain is worse at night; it may disappear when a tourniquet is applied.</p><p>May also present as haemorrhage under the nail. The presence of the <a href="/articles/hildreth-sign">Hildreth sign</a> (pain following application of a tourniquet proximally) is considered pathognomonic on clinical grounds <sup>7</sup>.</p><h4>Pathology</h4><p>Glomus tumours originate from the neuromyoarterial plexus: modified smooth muscle cells of the <a href="/articles/glomus-body">glomus body</a>. They are best thought of as harmatomas rather than true tumours. There are two main components on microscopy:</p><ul>- +<p><strong>Glomangiomas</strong>,<strong> </strong>also known as glomus tumours, are benign vascular tumours typically seen at the distal extremities. These tumours should not be confused with <a href="/articles/paraganglioma-1">paragangliomas</a> (sometimes referred to as glomus tumour). </p><h4>Epidemiology</h4><p>It classically presents in young to middle aged (4<sup>th</sup> to 5<sup>th</sup> decades <sup>7</sup>). There is a recognised female predilection. They can be multiple in ~ 10% of cases. Glomus tumors account for 1-5% of the soft-tissue tumors in the hand <sup>4</sup>.</p><h4>Clinical presentation</h4><p>The lesion usually presents as a small firm red-blue nodule under the finger nail and is exquisitely painful. Sometimes the pain is worse at night; it may disappear when a tourniquet is applied.</p><p>May also present as haemorrhage under the nail. The presence of the <a href="/articles/hildreth-sign">Hildreth sign</a> (pain following the application of a tourniquet proximally) is considered pathognomonic on clinical grounds <sup>7</sup>.</p><h4>Pathology</h4><p>Glomus tumours originate from the neuromyoarterial plexus: modified smooth muscle cells of the <a href="/articles/glomus-body">glomus body</a>. They are best thought of as harmatomas rather than true tumours. There are two main components on microscopy:</p><ul>
-<li>tumour is difficult if not impossible to identify - rarely can be seen as a subtle soft tissue density</li>- +<li>the tumour is difficult if not impossible to identify - rarely can be seen as a subtle soft tissue density</li>
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