Clinical and histopathological diagnosis of glomus tumor: A 6 year institutional retrospective study

Abstract

Background: Glomus tumors are rare and benign neoplasms that can be under diagnosed and commonly confused for melanocytic or vascular lesions [1]. Patients with such tumor can present to various medical specialties such as family medicine, orthopedics, dermatology or plastic surgery [2]. Those patients usually report a long duration of non-specific symptoms such as pain and temperature intolerance [2, 3]. It is common for such patients to undergo incorrect diagnosis, multiple imaging studies and potential delayed management [2, 3]. Methods: In this paper we are presenting the first study in the Kingdom of Bahrain to address a 6-year retrospective institutional review of all surgical histopathology cases of glomus tumor in a single medical center from 2014 to 2019. Results: A histopathological diagnosis of glomus tumor was most common in patients in their third to sixth decades of life. The mean patient age was 45.5 ± 11.9 (mean ± SD) years with 48% (15/31) males and 52% (16/31) females. 45% (14/31) of patients received the clinical diagnosis of glomus tumor at the initial presentation prior to the availability of the histopathology or imaging report. The mean patient age was 48.1 ± 12.9 (mean ± SD) years with equal presentation of males and female gender. The most common anatomical site reported was a lesion in the finger 71% (22/31). Other reported anatomical sites were in the toe 10% (3/31), arm 6% (2/31), leg 3% (1/31), foot 3% (1/31), back 3% (1/31), and middle ear 3% (1/31). The median glomus tumor specimen thickness was 0.35cm. The main differential diagnoses used at the initial presentation were glomus tumor 45% (14/31), lesion 10% (3/31), granuloma 6% (2/31), neuroma 6% (2/31), and epidermal cyst 3% (1/31). The majority of the patients with such tumors underwent X-Ray and Doppler Ultrasound (US) studies. Conclusion: This study demonstrated that glomus tumor occurred in several sites however the majority were located in the hand. There may be a role of cost-effective imaging study for example Doppler Ultrasound (US) in the early diagnosis and the management of patients with glomus tumor.