Subungual Glomus Tumor: A Review of 15 Cases Treated with Partial Nail Plate Excision Technique
Abstract
Background: Although there are various surgical methods for subungual glomus tumor treatment, there is no consensus on the optimal surgical approach.
Methods: We analyzed the outcomes of 15 patients treated with partial nail plate excision technique. The medial or lateral section of the nail plate was excised longitudinally based on the tumor location. After incision of the nail bed and tumor removal, the matrix was repaired carefully.
Results: In this study, 15 people, including 11 men and four women, were studied. The mean onset of symptoms until diagnosis was 88 months. In the postoperative evaluation, the mean follow-up was 20 months. Two patients had recurrent tumors, and one had postoperative nail deformity.
Conclusion: Meticulous nail bed repair and complete tumor excision are key treatment points needed to prevent nail deformity and recurrence.
1. Chou T, Pan SC, Shieh SJ, Lee JW, Chiu HY, Ho CL. Glomus Tumor: Twenty-year experience and literature review. Ann Plast Surg. 2016;76(Suppl 1):S35-S40. doi: 10.1097/SAP.0000000000000684. [PubMed: 26808758].
2. Reinders EFH, Klaassen KMG, Pasch MC. Transungual excision of glomus tumors: A treatment and quality of life study. Dermatol Surg. 2020;46(1):103-12. doi: 10.1097/DSS.0000000000002006. [PubMed: 31584524].
3. Tang CY, Tipoe T, Fung B. Where is the lesion? Glomus tumours of the hand. Arch Plast Surg. 2013;40(5):492-5. doi: 10.5999/aps.2013.40.5.492. [PubMed: 24086799]. [PubMed Central: PMC3785579].
4. Samaniego E, Crespo A, Sanz A. Key diagnostic features and treatment of subungual glomus tumor. Actas Dermosifiliogr. 2009;100(10):875-82. doi: 10.1016/S1578-2190(09)70558-X. Retrieved from. [PubMed: 20038364].
5. Gombos Z, Zhang PJ. Glomus tumor. Arch Pathol Lab Med. 2008;132(9):1448-52. doi: 10.5858/2008-132-1448-GT. [PubMed: 18788860].
6. Morey VM, Garg B, Kotwal PP. Glomus tumours of the hand: Review of literature. J Clin Orthop Trauma. 2016;7(4):286-91. doi: 10.1016/j.jcot.2016.04.006. [PubMed: 27857505]. [PubMed Central: PMC5106475].
7. Jawalkar H, Maryada VR, Brahmajoshyula V, Kotha GK. Subungual glomus tumors of the hand: Treated by transungual excision. Indian J Orthop. 2015;49(4):403-7. doi: 10.4103/0019-5413.159611. [PubMed: 26229160]. [PubMed Central: PMC4510793].
8. Madhar M, Bouslous J, Saidi H, Fikry T, Schuind F. Which approach is best for subungual glomus tumors? Transungual with microsurgical dissection of the nail bed or periungual? Chir Main. 2015;34(1):39-43. doi: 10.1016/j.main.2014.09.006. [PubMed: 25577556].
9. Nazerani S, Motamedi MH, Keramati MR. Diagnosis and management of glomus tumors of the hand. Tech Hand Up Extrem Surg. 2010;14(1):8-13. doi: 10.1097/BTH.0b013e3181c767d4. [PubMed: 20216046].
10. Singh D, Garg RS, Vikas, Garg Y, Arora V. Glomus Tumor - A Rarity; M.R.I- A big help in early Diagnosis. J Orthop Case Rep. 2016;6(3):38-9. doi: 10.13107/jocr.2250-0685.494. [PubMed: 28116265]. [PubMed Central: PMC5245934].
11. Lee SH, Roh MR, Chung KY. Subungual glomus tumors: surgical approach and outcome based on tumor location. Dermatol Surg. 2013;39(7):1017-22. doi: 10.1111/dsu.12181. [PubMed: 23463908].
12. Netscher DT, Aburto J, Koepplinger M. Subungual glomus tumor. J Hand Surg Am. 2012;37(4):821-3. doi: 10.1016/j.jhsa.2011.10.026. [PubMed: 22192165].
13. Bae TH, Kim HS, Lee JS. Eponychial flap elevation method for surgical excision of a subungual glomus tumor. Dermatol Ther. 2020;33(6):e14330. doi: 10.1111/dth.14330. [PubMed: 32975348].
14. Vasisht B, Watson HK, Joseph E, Lionelli GT. Digital glomus tumors: a 29-year experience with a lateral subperiosteal approach. Plast Reconstr Surg. 2004;114(6):1486-9. doi: 10.1097/01.prs.0000138752.36175.d5 . [PubMed: 15509936].
15. Mehrotra S, Singh V, Dadwal U. Subungual glomus tumour excision: The nail plate flap technique. J Surg Dermatol. 2017;2(3):1-5. doi: 10.18282/jsd.
16. Frumuseanu B, Balanescu R, Ulici A, Golumbeanu M, Barbu M, Orita V, et al. A new case of lower extremity glomus tumor up- to date review and case report. J Med Life. 2012;5(2):211-4. Retrieved from. [PubMed: 22802895]. [PubMed Central:PMC3391884].
17. Orellana F, Onetto C, Balbontin P, Videla D, Manriquez L, Plass R, et al. Gastric glomus tumor: Report of one case and review. Endoscopy. 2011;43(Suppl 2 UCTN): E71-E72. doi: 10.1055/s-0030- 1256041. [PubMed: 21341189].
18. Aslam N, Qazi ZU, Ahmad AH, Khan RU. Malignant glomus tumour of larynx: First case report and literature review. J Laryngol Otol. 2012;126(7):743-6. doi: 10.1017/S0022215112000631. [PubMed: 22578259].
19. Nambi GI, Varanambigai TKA. Excision of subungual glomus tumor by subungual approach: A useful yet underutilized technique. J Cutan Aesthet Surg. 2019;12(3):187-90. doi: 10.4103/JCAS.JCAS_28_19. [PubMed: 31619892].
20. Muramatsu K, Ihara K, Hashimoto T, Tominaga Y, Taguchi T. Subungual glomus tumours: diagnosis and microsurgical excision through a lateral subperiosteal approach. J Plast Reconstr Aesthet Surg. 2014;67(3):373-6. doi: 10.1016/j.bjps.2013.11.006. [PubMed: 24411667].
21. Lee HJ, Kim PT, Kyung HS, Kim HS, Jeon IH. Nail-preserving excision for subungual glomus tumour of the hand. J Plast Surg Hand Surg. 2014;48(3):201-4. doi: 10.3109/2000656X.2013.861842. [PubMed: 24256308].
22. Lee W, Kwon SB, Cho SH, Eo SR, Kwon C. Glomus tumor of the hand. Arch Plast Surg. 2015;42(3):295-301. doi: 10.5999/aps.2015.42.3.295. [PubMed: 26015884]. [PubMed Central: PMC4439588].
23. Santoshi JA, Kori VK, Khurana U. Glomus tumor of the fingertips: A frequently missed diagnosis. J Family Med Prim Care. 2019;8(3):904-8. doi: 10.4103/jfmpc.jfmpc_88_19 . [PubMed: 31041222]. [PubMed Central: PMC6482761].
24. Macharia C, Nthumba. Glomus tumor presenting as complex regional pain syndrome of the left upper limb: a case report. J Med Case Rep. 2015;9:293. doi: 10.1186/s13256-015-0793-3. [PubMed: 26715068]. [PubMed Central: PMC469340].
25. Thakur BK, Verma S, Jitani A. Subungual glomus tumour excision with transungual approach with partial proximal nail avulsion. J Cutan Aesthet Surg. 2016;9(3):207-9. doi: 10.4103/0974-2077.191654. [PubMed: 27761095]. [PubMed Central: PMC5064689].
26. Moon SE, Won JH, Kwon OS, Kim JA. Subungual glomus tumor: clinical manifestations and outcome of surgical treatment. J Dermatol. 2004;31(12):993-7. doi: 10.1111/j.1346- 8138.2004.tb00643.x. [PubMed: 15801264].
27. Kale SS, Rao VK, Bentz ML. Glomus tumor of the index finger. J Craniofac Surg. 2006;17(4):801-4. doi: 10.1097/00001665- 200607000-00037. [PubMed: 16877938].
28. Stewart DR, Sloan JL, Yao L, Mannes AJ, Moshyedi A, Lee CC, et al. Diagnosis, management, and complications of glomus tumours of the digits in neurofibromatosis type 1. J Med Genet. 2010;47(8):525-32. doi: 10.1136/jmg.2009.073965. [PubMed: 20530151]. [PubMed Central: PMC3412429].
29. Song M, Ko HC, Kwon KS, Kim MB. Surgical treatment of subungual glomus tumor: a unique and simple method. Dermatol Surg. 2009;35(5):786-91. doi: 10.1111/j.1524- 4725.2009.01129.x. [PubMed: 19389101].
30. Faisan SD, Chaput B, Grolleau JL, Rongieres M, Mansat P. Improvement in quality of life after surgery for glomus tumors of the fingers. Chir Main. 2014;33(5):330-5. doi: 10.1016/j.main.2014.07.001. [PubMed: 25218648].
31. Lee IJ, Park DH, Park MC, Pae NS. Subungual glomus tumours of the hand: diagnosis and outcome of the transungual approach. J Hand Surg Eur Vol. 2009;34(5):685-8. doi: 10.1177/1753193408104799. [PubMed: 19959449].
2. Reinders EFH, Klaassen KMG, Pasch MC. Transungual excision of glomus tumors: A treatment and quality of life study. Dermatol Surg. 2020;46(1):103-12. doi: 10.1097/DSS.0000000000002006. [PubMed: 31584524].
3. Tang CY, Tipoe T, Fung B. Where is the lesion? Glomus tumours of the hand. Arch Plast Surg. 2013;40(5):492-5. doi: 10.5999/aps.2013.40.5.492. [PubMed: 24086799]. [PubMed Central: PMC3785579].
4. Samaniego E, Crespo A, Sanz A. Key diagnostic features and treatment of subungual glomus tumor. Actas Dermosifiliogr. 2009;100(10):875-82. doi: 10.1016/S1578-2190(09)70558-X. Retrieved from. [PubMed: 20038364].
5. Gombos Z, Zhang PJ. Glomus tumor. Arch Pathol Lab Med. 2008;132(9):1448-52. doi: 10.5858/2008-132-1448-GT. [PubMed: 18788860].
6. Morey VM, Garg B, Kotwal PP. Glomus tumours of the hand: Review of literature. J Clin Orthop Trauma. 2016;7(4):286-91. doi: 10.1016/j.jcot.2016.04.006. [PubMed: 27857505]. [PubMed Central: PMC5106475].
7. Jawalkar H, Maryada VR, Brahmajoshyula V, Kotha GK. Subungual glomus tumors of the hand: Treated by transungual excision. Indian J Orthop. 2015;49(4):403-7. doi: 10.4103/0019-5413.159611. [PubMed: 26229160]. [PubMed Central: PMC4510793].
8. Madhar M, Bouslous J, Saidi H, Fikry T, Schuind F. Which approach is best for subungual glomus tumors? Transungual with microsurgical dissection of the nail bed or periungual? Chir Main. 2015;34(1):39-43. doi: 10.1016/j.main.2014.09.006. [PubMed: 25577556].
9. Nazerani S, Motamedi MH, Keramati MR. Diagnosis and management of glomus tumors of the hand. Tech Hand Up Extrem Surg. 2010;14(1):8-13. doi: 10.1097/BTH.0b013e3181c767d4. [PubMed: 20216046].
10. Singh D, Garg RS, Vikas, Garg Y, Arora V. Glomus Tumor - A Rarity; M.R.I- A big help in early Diagnosis. J Orthop Case Rep. 2016;6(3):38-9. doi: 10.13107/jocr.2250-0685.494. [PubMed: 28116265]. [PubMed Central: PMC5245934].
11. Lee SH, Roh MR, Chung KY. Subungual glomus tumors: surgical approach and outcome based on tumor location. Dermatol Surg. 2013;39(7):1017-22. doi: 10.1111/dsu.12181. [PubMed: 23463908].
12. Netscher DT, Aburto J, Koepplinger M. Subungual glomus tumor. J Hand Surg Am. 2012;37(4):821-3. doi: 10.1016/j.jhsa.2011.10.026. [PubMed: 22192165].
13. Bae TH, Kim HS, Lee JS. Eponychial flap elevation method for surgical excision of a subungual glomus tumor. Dermatol Ther. 2020;33(6):e14330. doi: 10.1111/dth.14330. [PubMed: 32975348].
14. Vasisht B, Watson HK, Joseph E, Lionelli GT. Digital glomus tumors: a 29-year experience with a lateral subperiosteal approach. Plast Reconstr Surg. 2004;114(6):1486-9. doi: 10.1097/01.prs.0000138752.36175.d5 . [PubMed: 15509936].
15. Mehrotra S, Singh V, Dadwal U. Subungual glomus tumour excision: The nail plate flap technique. J Surg Dermatol. 2017;2(3):1-5. doi: 10.18282/jsd.
16. Frumuseanu B, Balanescu R, Ulici A, Golumbeanu M, Barbu M, Orita V, et al. A new case of lower extremity glomus tumor up- to date review and case report. J Med Life. 2012;5(2):211-4. Retrieved from. [PubMed: 22802895]. [PubMed Central:PMC3391884].
17. Orellana F, Onetto C, Balbontin P, Videla D, Manriquez L, Plass R, et al. Gastric glomus tumor: Report of one case and review. Endoscopy. 2011;43(Suppl 2 UCTN): E71-E72. doi: 10.1055/s-0030- 1256041. [PubMed: 21341189].
18. Aslam N, Qazi ZU, Ahmad AH, Khan RU. Malignant glomus tumour of larynx: First case report and literature review. J Laryngol Otol. 2012;126(7):743-6. doi: 10.1017/S0022215112000631. [PubMed: 22578259].
19. Nambi GI, Varanambigai TKA. Excision of subungual glomus tumor by subungual approach: A useful yet underutilized technique. J Cutan Aesthet Surg. 2019;12(3):187-90. doi: 10.4103/JCAS.JCAS_28_19. [PubMed: 31619892].
20. Muramatsu K, Ihara K, Hashimoto T, Tominaga Y, Taguchi T. Subungual glomus tumours: diagnosis and microsurgical excision through a lateral subperiosteal approach. J Plast Reconstr Aesthet Surg. 2014;67(3):373-6. doi: 10.1016/j.bjps.2013.11.006. [PubMed: 24411667].
21. Lee HJ, Kim PT, Kyung HS, Kim HS, Jeon IH. Nail-preserving excision for subungual glomus tumour of the hand. J Plast Surg Hand Surg. 2014;48(3):201-4. doi: 10.3109/2000656X.2013.861842. [PubMed: 24256308].
22. Lee W, Kwon SB, Cho SH, Eo SR, Kwon C. Glomus tumor of the hand. Arch Plast Surg. 2015;42(3):295-301. doi: 10.5999/aps.2015.42.3.295. [PubMed: 26015884]. [PubMed Central: PMC4439588].
23. Santoshi JA, Kori VK, Khurana U. Glomus tumor of the fingertips: A frequently missed diagnosis. J Family Med Prim Care. 2019;8(3):904-8. doi: 10.4103/jfmpc.jfmpc_88_19 . [PubMed: 31041222]. [PubMed Central: PMC6482761].
24. Macharia C, Nthumba. Glomus tumor presenting as complex regional pain syndrome of the left upper limb: a case report. J Med Case Rep. 2015;9:293. doi: 10.1186/s13256-015-0793-3. [PubMed: 26715068]. [PubMed Central: PMC469340].
25. Thakur BK, Verma S, Jitani A. Subungual glomus tumour excision with transungual approach with partial proximal nail avulsion. J Cutan Aesthet Surg. 2016;9(3):207-9. doi: 10.4103/0974-2077.191654. [PubMed: 27761095]. [PubMed Central: PMC5064689].
26. Moon SE, Won JH, Kwon OS, Kim JA. Subungual glomus tumor: clinical manifestations and outcome of surgical treatment. J Dermatol. 2004;31(12):993-7. doi: 10.1111/j.1346- 8138.2004.tb00643.x. [PubMed: 15801264].
27. Kale SS, Rao VK, Bentz ML. Glomus tumor of the index finger. J Craniofac Surg. 2006;17(4):801-4. doi: 10.1097/00001665- 200607000-00037. [PubMed: 16877938].
28. Stewart DR, Sloan JL, Yao L, Mannes AJ, Moshyedi A, Lee CC, et al. Diagnosis, management, and complications of glomus tumours of the digits in neurofibromatosis type 1. J Med Genet. 2010;47(8):525-32. doi: 10.1136/jmg.2009.073965. [PubMed: 20530151]. [PubMed Central: PMC3412429].
29. Song M, Ko HC, Kwon KS, Kim MB. Surgical treatment of subungual glomus tumor: a unique and simple method. Dermatol Surg. 2009;35(5):786-91. doi: 10.1111/j.1524- 4725.2009.01129.x. [PubMed: 19389101].
30. Faisan SD, Chaput B, Grolleau JL, Rongieres M, Mansat P. Improvement in quality of life after surgery for glomus tumors of the fingers. Chir Main. 2014;33(5):330-5. doi: 10.1016/j.main.2014.07.001. [PubMed: 25218648].
31. Lee IJ, Park DH, Park MC, Pae NS. Subungual glomus tumours of the hand: diagnosis and outcome of the transungual approach. J Hand Surg Eur Vol. 2009;34(5):685-8. doi: 10.1177/1753193408104799. [PubMed: 19959449].
| Files | ||
| Issue | Vol 7, No 3 (2021) | |
| Section | Research Articles | |
| DOI | https://doi.org/10.18502/jost.v7i3.8102 | |
| Keywords | ||
| Glomus Tumor; Treatment; Hand | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Farzan M, Neshan M, Farhoud AR, Abdoli A. Subungual Glomus Tumor: A Review of 15 Cases Treated with Partial Nail Plate Excision Technique. J Orthop Spine Trauma. 2022;7(3):77-80.
