Intravascular Glomus Tumor of the Forearm Causing Chronic Pain and Focal Tenderness

Abstract

Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition. Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI) showed a mass measuring 5 × 3 × 2 mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient's symptoms were completely resolved postoperatively. Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis.

Intracephalic glomus tumor presenting as peripheral neuropathic pain and literature review

“…The of injury have b nd no history o mptoms and we l pain, localized ent with neuro lomus tumor c of Diagnostic Im between the tw mor cells wer fter the comple in up to 4 year e skin circulatio [8] . [9,13,14] . However, glomus cells are adjacent to a rich neural bed; this may explain the severe neuropathic pain and cold hypersensitivity associated with these lesions.…”

“…As previously mentioned, the forearm is the most common extra digital location, and the lesions most commonly occur in the subcutaneous layer, with very infrequent occurrence in extra cutaneous locations such as muscle, bone, and blood vessels [10,15] . Superficially located glomus tumors often produce typical symptoms such as paroxysmal pain, exacerbated by changes in temperature [9] . However, glomus tumors located at an unusual site may present with features of no pain or hypersensitivity [14,15] .…”

“…However, glomus tumors located at an unusual site may present with features of no pain or hypersensitivity [14,15] . Interestingly, those located at unusual extra cutaneous sites may or may not present with features of neuropathic pain [8,9,15] . Indeed, there was no sensory alteration in the current case in which the glomus tumor was located intravascularly.…”

“…They have been reported to be more common in men. Extra cutaneous glomus tumors were reported rarely in the stomach, gastric antrum, colon, mesentery, mediastinum, trachea, and cervix [8,9] . The forearm is the most common extra digital location, and the lesions most commonly occur in the subcutaneous layer.…”

“…Extra cutaneous glomus tumors occur very infrequently in locations such as muscle, bone, periosteal, intravascular and intraneural layers [10,11] . They are usually solitary but a multiple glomus tumor syndrome has been described and is transmitted in an autosomal dominant pattern [9] . The etiology of glomus tumor is not clear.…”