Original Research Paper developed lancinating type of pain in the - PDF document

BACKGROUND: Laboratory diagnosis for screening tests were all negative. contact radial border of nger. phalanx of right middle nger was made to avoid scar on the A curvilinear incision with convexity to ulnar side of terminal block anaesthesia and tourniquet control using a tourniquet. surgery was done under loupe magnication, under digital patient was taken up for excision biopsy of the lesion. The Treatment: With a clinical diagnosis of glomus tumour the Figure 2: Plain radiography ndings were unremarkable. Plain X-ray of the right hand was taken. Investigations: AND DIAGNOSTIC PEARLS vascular or melanocytic lesions and lipoma. with other differential diagnosis including the possibility of A clinical diagnosis of glomus tumour was considered along Clinical diagnosis and differential diagnosis: middle nger. Figure 1: There was no obvious swelling in the pulp of centimeter was identied. palpation a tender, diffuse, palpable mass measuring 0.5 terminal phalanx, slightly ulnar to midline and on deep Palpation elicited severe tenderness on the pulp of the GLOMUS TUMOR IN THE PULP OF FINGER – A RARE PRESENTATION Original Research Paper developed lancinating type of pain in the digit. On clinical tumors of Hand. and Research, Porur, Chennai-600116 Department of Pathology Sri Ramachandra Institute of Higher Education Sundaram Dr Sandhya Education and Research, Porur, Chennai-600116 Department of Hand surgery Sri Ramachandra Institute of Higher Dr. N. Mariappan Glomangiomyoma, Sucquet-hoyer Canal. KEYWORDS : Glomus Tumour, Glomangioma, Glomangiomatosis, Perivascular Neoplasm, Sub-ungual ABSTRACT pulp of nger. We also discuss clinical, histopathological and immunohistochemistry diagnosis and management of glomus Dr. M Srivignesh* nocturnal or rest hand pain. We present a unique case of 73-year-old male patient treated for rare presentation of the tumor at the intolerance. Possibility of glomus tumour must be considered in the differential diagnosis for evaluation of unexplained They present with severe pain out of proportion to the size of the tumor and are associated with severe cold Summary: Glomus tumors are rare and occur typically in the subungual region of the digits of extremities. Plastic Surgery GJRA - GLOBAL JOURNAL FOR RESEARCH ANALYSIS X 53 Education and Research, Porur, Chennai-600116 *Corresponding Author Department of Hand surgery Sri Ramachandra Institute of Higher examination of right middle nger there is no visible swelling. Initially the patient noticed cold intolerance and then Glomus tumours are benign perivascular neoplasms that pressure and skin temperature through arterio-venous smooth muscle cells of neuromyo-arterial component of Glomus tumours are benign lesions arising from modied tumour size, cold sensitivity and severe point tenderness [4]. paroxysmal pain that is worse at night, out of proportion to present with a triad of symptoms including excruciating usually less than one centimetre in size. Patients typically of the glomus body. They are relatively uncommon and shunting of blood. Glomus tumour arises from the arterial end arteriovenous dermal shunt that normally control blood They are found more in subungual regions of digits, in the from 1 to 7 years. Glomus body is an innervated coiled literature. The period of evolution of glomus tumour ranges the pulp of nger in pregnant women has been reported in of pulp of a nger is very rare. An exophytic glomus tumour on regions, as well as in the nail matrix, nail bed and involvement . In the hand they are often found in the subungual of digits [1,2,3] arising in the hand, with fewer than 10% involve the volar pulp originate from glomus bodies and comprise just 1% of tumours glomus body. Histologically they resemble glomus bodies. subcutis and supercial soft tissues deep dermis of the palm, hypertensive and does not have any other medical condition. [7] There is no history of trauma. He is not diabetic, not of pain in the pulp of his right mid nger of 6 years duration. presented to Hand surgery outpatient Department with history A 73 years old right handed male working as a security guard Case presentation: the common form of glomus tumours. Glomangioma and glomangio-myoma are classic variants of seated large tumours in the gastro-intestinal system. tumours are exceedingly rare and more frequently are deep- around vessels . Atypical or frankly malignant glomus sheets of cells with oval nuclei, forming a perivascular “collar” [5] features of the glomus tumour include angiocentric uniform muscle cells, and vasculature. The classical histological are typically composed of 3 components: glomus cells, smooth evident for presentation in other locations. Glomus tumours female preponderance and there is no sex predilection and genitourinary tract . Subungual presentation has a [6] including the lung, liver stomach, pancreas, gastrointestinal, than 1cm) blue-red nodule and may occur in different viscera wrist, and forearm . Glomus tumour appear as small (less VOLUME-8, ISSUE-11, NOVEMBER-2019 • PRINT ISSN No. 2277 - 8160 • DOI : 10.36106/gjra