Genetic Disease Research Branch, National Human Genome Research Institute, National Institutes of Health, 49 Convent Drive, Building 49, Room 4A62, Bethesda, MD 20892, USA.
J Med Genet. 2010 Aug;47(8):525-32. doi: 10.1136/jmg.2009.073965. Epub 2010 Jun 7.
Glomus tumours are benign painful tumours of the glomus body, a thermoregulatory shunt in the digits. Glomus tumours of the fingers and toes are associated with the monogenic disorder neurofibromatosis type 1 (NF1) and are recently recognised as part of the NF1 phenotype.
A multi-institutional experience with 15 individuals with NF1 and glomus tumours of the fingers or toes is reported. The majority of individuals presented with at least two of the symptoms in the classic triad of localised tenderness, severe paroxysmal pain, and sensitivity to cold. Appearance of the nail and finger or toe is often normal. Women are affected more often than men. Multifocal tumours are common. There is often a delay in diagnosis of many years and clinical suspicion is key to diagnosis, although magnetic resonance imaging may be useful in some scenarios. Surgical extirpation can be curative; however, local tumour recurrence and metachronous tumours are common. Three of our patients developed signs and symptoms of the complex regional pain syndrome.
Glomus tumours in NF1 are more common than previously recognised and NF1 patients should be specifically queried about fingertip or toe pain.
血管球瘤是一种位于指(趾)部的血管球的良性痛性肿瘤,血管球是一种调节体温的短路。手指和脚趾的血管球瘤与单基因疾病神经纤维瘤病 1 型(NF1)有关,最近被认为是 NF1 表型的一部分。
报告了一个多机构的 NF1 患者伴手指或脚趾血管球瘤的 15 例患者的经验。大多数患者至少出现经典三联征的两个症状,即局部压痛、剧烈阵发性疼痛和对冷敏感。指甲和手指或脚趾的外观通常正常。女性比男性更常受累。多灶性肿瘤很常见。通常存在多年的诊断延迟,临床怀疑是诊断的关键,尽管磁共振成像在某些情况下可能有用。手术切除可以治愈,但局部肿瘤复发和同时性肿瘤很常见。我们的 3 名患者出现了复杂性区域疼痛综合征的体征和症状。
NF1 中的血管球瘤比以前认识到的更为常见,应特别询问 NF1 患者指尖或脚趾疼痛的情况。