Foot & Ankle Surgery: Techniques, Reports & Cases (Jan 2024)

Symptomatic glomus tumor in the foot: A case report

  • Niral A. Patel, DPM, MS,
  • Zachary Hulst, DPM,
  • Carina Dehner, MD, PhD,
  • Douglas Blacklidge, DPM

Journal volume & issue
Vol. 4, no. 1
p. 100360

Abstract

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Introduction: Glomus tumors, originating from thermoregulatory cells known as glomus bodies, are typically benign neoplasms with a rare malignant variant. While commonly found in the hand, particularly in the subungual tissues, their occurrence in the foot is exceedingly rare. This case report details a symptomatic subungual glomus tumor in a 52-year-old female, discussing the literature's limited information on pedal glomus tumors. Case: The patient presented with severe pain under her left second toenail, with a physical examination revealing discoloration, onycholysis, and a soft tissue mass. MRI confirmed a subungual mass, consistent with a glomus tumor. Surgical excision was performed, and pathology confirmed the diagnosis. Despite focal symplastic features, the tumor was classified as benign. Discussion: Clinical presentation of subungual glomus tumors varies, necessitating thorough physical examination and consideration of clinical tests such as the Love, Hildreth, and cold tests. Advanced imaging, particularly MRI, is crucial for diagnosis. Histopathological evaluation, guided by specific criteria, helps differentiate benign from malignant glomus tumors. Conclusion: Given the rarity of subungual glomus tumors, current literature relies heavily on hand-related studies. This case underscores the importance of considering glomus tumors in cases of subungual pain, discoloration, or dystrophy, emphasizing the need for surgical excision to alleviate symptoms and prevent recurrence. High-powered studies are challenging due to the tumor's rare occurrence, highlighting the necessity for continued research to strengthen the literature on this topic.

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