Glomus tumors are uncommon tumors and their occurrence in the foot is even less common. Glomus tumors of the toes are often missed, causing delays in diagnosis and treatment. We report an ambispective observational study of glomus tumors of the toes that were treated at our institution.
Methods:
We reviewed the records of all the patients who underwent excision of toe glomus tumors in our department from January 2010 to September 2022. The follow-up data were collected from the outpatient records and by telephonic interview. Single Assessment Numeric Evaluation (SANE) score, Foot and Ankle Outcome Score (FAOS), and the Foot Function Index (FFI) were collected.
Results:
Out of all the patients treated for glomus tumors, we found that 7 patients had glomus tumors of the toes. Of the 7 patients, 6 were women and 1 was a male. The mean follow-up of our patients was 66.4 months (range, 7-109 months). Of the 7 patients, 1 presented with recurrent glomus tumor 30 months following the primary operation, for which she underwent excision again, after which she was symptom free. Another patient who developed recurrent symptoms on telephonic interview refused any further treatment. Among the 6 patients who were symptom-free at follow-up (including the patient who underwent excision for the recurrent tumor), the median SANE score, and FFI were 99.5 (IQR, 96-100) and 0.5 (IQR, 0-2) respectively. The mean FAOS was 96 (SD, 3.3).
Conclusion:
Surgical excision of the subungual toe glomus tumors can be curative. Recurrence of toe glomus tumors was noted in 2 patients (29%), one of whom refused further surgery. Re-excision in the other patient resulted in complete resolution of symptoms.
BarreJAMassonP.Etude anatoma-clinique de certaines tumeurs sous - Ungueales doulooreuses [Anatomo-clinical study of certain painful subungual tumors]. Bull Soc Dermatol Syph. 1924;31:148-159.
2.
BenetosISThemistocleousGSMaheraHJChlorosGDSoucacosPN.Painful toe in a 51-year-old man. Clin Orthop Relat Res. 2006;449:313-319. doi:10.1097/01.blo.0000229326.83534.7a
3.
CarrollREBermanAT.Glomus tumors of the hand: review of the literature and report on twenty-eight cases. J Bone Joint Surg Am. 1972;54(4):691-703.
4.
ChenSHTChenYLChengMHYeowKMChenHCWeiFC. The use of ultrasonography in preoperative localization of digital glomus tumors. Plast Reconstr Surg. 2003;112(1):115-119; discussion 120. doi:10.1097/01.PRS.0000066163.81401.05
5.
DailianaZHDrapéJLLe VietD.A glomus tumour with four recurrences. J Hand Surg Br. 1999;24(1):131-132. doi:10.1054/jhsb.1998.0047
6.
EdwardsSRBaariniOHaddadA.A painful glomus tumour of the toe: a case report. Foot Ankle Surg Tech Rep Cases. 2022;2(2):100204. doi:10.1016/j.fastrc.2022.100204
7.
GandhiJYangSSHurdJ.The anatomic location of digital glomus tumor recurrences. J Hand Surg Am. 2010;35(6):986-989. doi:10.1016/j.jhsa.2010.02.019
8.
GieleH.Hildreth’s test is a reliable clinical sign for the diagnosis of glomus tumours. J Hand Surg Br. 2002;27(2):157-158. doi:10.1054/jhsb.2001.0724
9.
GombosZFogtFZhangPJ.Intraosseous glomus tumor of the great toe: a case report with review of the literature. J Foot Ankle Surg. 2008;47(4):299-301. doi:10.1053/j.jfas.2008.04.003
10.
GouldEP.Sclerotherapy for multiple glomangiomata. J Dermatol Surg Oncol. 1991;17(4):351-352. doi:10.1111/j.1524-4725.1991.tb01710.x
11.
HallRMOdellJE.An unusually large glomangioma simulating osteoarthritis of the hip. JAMA. 1970;214(8):1562. doi:10.1001/jama.1970.03180080142028
HorstFNunleyJA.Technique tip: glomus tumors in the foot: a new surgical technique for removal. Foot Ankle Int. 2003;24(12):949-951. doi:10.1177/107110070302401215
14.
JosephFRPosnerMA.Glomus tumors of the wrist. J Hand Surg Am. 1983;8(6):918-920. doi:10.1016/S0363-5023(83)80095-1
15.
KaracaMOBaşarırKMerterA, et al. Malignant tumors of the foot and ankle. Foot Ankle Int. 2022;43(9):1232-1241. doi:10.1177/10711007221097654
16.
KimuraTKubotaMHattoriHSaitoM.Simultaneous glomus tumors of the third and fourth toes: a case report. JBJS Case Connect. 2022;12(2):e21.00780. doi:10.2106/JBJS.CC.21.00780
17.
KlopingLPWidhiyantoLIriantoKASindrawatiOKlopingYP.Glomus tumor-induced lower extremity pain: a case report. Int J Surg Case Rep. 2020;75:352-356. doi:10.1016/j.ijscr.2020.09.093
18.
KotiMBhattacharryyaREwenSWMaffulliN.Subungual glomus tumor of the hallux. A case report. Acta Orthop Belg. 2001;67(3):297-299.
19.
LeeIJParkDHParkMCPaeNS.Subungual glomus tumours of the hand: diagnosis and outcome of the transungual approach. J Hand Surg Eur Vol. 2009;34(5):685-688. doi:10.1177/1753193408104799
LumleyJSStansfeldAG.Infiltrating glomus tumour of lower limb. Br Med J. 1972;1(5798):484-485. doi:10.1136/bmj.1.5798.484
26.
MadharMBouslousJSaidiHFikryTSchuindF.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
27.
MassariLCarusoGChinniCFerronPGabanATrainaF.Intraosseous glomus tumor of the ankle: a case report and review of the literature. Foot Ankle Int. 2006;27(12):1148-1151. doi:10.1177/107110070602701223
28.
MatloubHSMuonekeVNPrevelCDSangerJRYousifNJ.Glomus tumor imaging: use of MRI for localization of occult lesions. J Hand Surg Am. 1992;17(3):472-475. doi:10.1016/0363-5023(92)90353-Q
29.
MaxwellGPCurtisRMWilgisEFS. Multiple digital glomus tumors. J Hand Surg Am. 1979;4(4):363-367. doi:10.1016/S0363-5023(79)80076-3
30.
McDermottEMWeissAPC. Glomus tumors. J Hand Surg Am. 2006;31(8):1397-1400. doi:10.1016/j.jhsa.2006.05.018
31.
MiyanoJAFitzgibbonsTC.Glomangioma of the ankle simulating injury to the flexor hallucis longus: a case report. Foot Ankle Int. 1996;17(12):768-770. doi:10.1177/107110079601701210
32.
MohindraMSambandamBGautamVKMainiL.A rare case of glomus tumor of the great toe: an analysis of behavior at this rare site. Foot Ankle Spec. 2016;9(1):83-87. doi:10.1177/1938640015578517
33.
MohlerDGLimCKMartinB.Glomus tumor of the plantar arch: a case report with magnetic resonance imaging findings. Foot Ankle Int. 1997;18(10):672-674. doi:10.1177/107110079701801014
34.
MuramatsuKIharaKHashimotoTTominagaYTaguchiT.Subungual glomus tumours: diagnosis and microsurgical excision through a lateral subperiosteal approach. J Plast Reconstr Aesthet Surg. 2014;67(3):373-376. doi:10.1016/j.bjps.2013.11.006
35.
NetscherDTAburtoJKoepplingerM.Subungual glomus tumor. J Hand Surg Am. 2012;37(4):821-823. doi:10.1016/j.jhsa.2011.10.026
36.
NishimotoKNishimotoMYamamotoSNakagawaTTakaiwaTTanabeM.Multiple glomus tumours: successful treatment with electron beam irradiation. Br J Dermatol. 1990;123(5):657-661. doi:10.1111/j.1365-2133.1990.tb01484.x
37.
PaterTJMarksRM.Glomus tumor of the hallux: case presentation and review of the literature. Foot Ankle Int. 2004;25(6):434-437. doi:10.1177/107110070402500614
38.
PoloCBordaDPoggioDAsunciónJPeidroL.Glomus tumor of the hallux. Review of the literature and report of two cases. Foot Ankle Surg. 2012;18(2):89-93. doi:10.1016/j.fas.2011.05.005
39.
RettigACStricklandJW.Glomus tumor of the digits. J Hand Surg Am. 1977;2(4):261-265. doi:10.1016/S0363-5023(77)80121-4
40.
RkibaZRafaiMRajaallahAElkassimiCGarchA.Malignant glomus tumor of the foot. Case report. Int J Surg Case Rep. 2021;79:413-416. doi:10.1016/j.ijscr.2021.01.050
41.
RomanosEDelfiFAHubballahMFarahC.Glomus tumour of the fourth toe: case discussion and review of literature. BMJ Case Rep. 2019;12(11):e231100. doi:10.1136/bcr-2019-231100
42.
SapuanJPaulAGAbdullahS.Glomus tumor in the second toe: a clinical insight. J Foot Ankle Surg. 2008;47(5):483-486. doi:10.1053/j.jfas.2008.05.008
43.
SbaiMABenzartiSGharbiWKhoffiWMaallaR.Glomus tumor of the leg: a case report. Pan Afr Med J. 2018;31:186. doi:10.11604/pamj.2018.31.186.9706
44.
SeoJHLeeHSKimSWJeongJJChoiYR.Subungual glomus cell proliferation in the toe: a case report. J Foot Ankle Surg. 2014;53(5):628-630. doi:10.1053/j.jfas.2014.03.004
45.
SprinkleRLBSanguezaOPSchwartzGA. Glomus tumor of the toe: an anatomical variant. J Am Podiatr Med Assoc. 2017;107(3):257-260. doi:10.7547/15-161
46.
TadaHHiraymaTTakemitsuY.Prevention of postoperative nail deformity after subungual glomus resection. J Hand Surg Am. 1994;19(3):500-503. doi:10.1016/0363-5023(94)90070-1
47.
TehraniHShahDSidhuSMayKMorrisA.Treatment of recurrent glomus tumor using mohs surgery. Dermatol Surg. 2012;38(3):502. doi:10.1111/j.1524-4725.2011.02224.x
48.
TrehanSKSoukupDSMintzDNPerinoGEllisSJ.Glomus tumors in the foot: case series. Foot Ankle Spec. 2015;8(6):460-465. doi:10.1177/1938640015583514
49.
TsuchieHOkadaKNagasawaHMinagawaHShimadaY.Glomus tumor of the toe with symptoms similar to those of Morton’s disease. J Orthop Sci. 2009;14(6):826-829. doi:10.1007/s00776-009-1387-y
50.
Van GeertruydenJLoreaPGoldschmidtD, et al. Glomus tumours of the hand: a retrospective study of 51 cases. J Hand Surg Br. 1996;21(2):257-260. doi:10.1016/S0266-7681(96)80110-0
51.
VasishtBWatsonHKJosephELionelliGT.Digital glomus tumors: a 29-year experience with a lateral subperiosteal approach. Plast Reconstr Surg. 2004;114(6):1486. doi:10.1097/01.PRS.0000138752.36175.D5
52.
WeiserJANordKMGrossmanME.Glomus tumor masquerading for 22 years as osteoarthritis of the hip. Cutis. 2008;81(4):339-342.
53.
WHO Classification of Tumours Editorial Board, International Academy of Pathology. WHO Classification of Tumours of Soft Tissue and Bone Tumours. 5th ed. (FletcherCDM, ed.). IARC; 2020.
54.
WoodW.On painful subcutaneous tubercle. Edinb Med Surg J. 1812;8(31):283-291.
55.
WorkmanMSaragasNPFerraoP.Glomus tumors in the foot: two case reports. J Foot Ankle. 2020;14(2):183-186. doi:10.30795/jfootankle.2020.v14.1179
56.
YoshimotoSIchinoseMUdagawaAKurokiTShimizuS.A case of invisible glomus tumor in an unusual site. Ann Plast Surg. 1999;43(3):336-338. doi:10.1097/00000637-199909000-00025
57.
YuYHLeeCHLinSH.Minimally invasive transungual tumors enucleation with nail preservation for subungual glomus tumors. Dermatol Surg. 2021;47(4):e138. doi:10.1097/DSS.0000000000002847
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
