Paliogiannis Panagiotis, Trignano Emilio, Trignano Mario
Istituto di Patologia Chirurgica, Università di Sassari, Italy.
Ann Ital Chir. 2011 Nov-Dec;82(6):465-8.
Glomus tumors are rare neoplasms arising from the subcutaneous glomus apparatus. They account for 1 - 5% of the soft tissue tumors of the upper extremity, occurring in most cases in the nail bed. The typical clinical presentation includes paroxysmal pain and hypersensitivity to cold which limit the use of the affected hand causing practical, professional and often emotional discomfort for the patient.
Four patients with finger glomus tumor were treated in our institution in the last 30 years. Three patients had a right hand tumor (1st, 3rd and 4th finger) and one patient a left hand tumor (2nd finger). Three tumors were placed in the nail bed and one in the finger tip. In all cases duplex ultrasonography was employed preoperatively and during surgery to ensure complete resection of the tumor. All patients underwent surgical excision of the tumor with local block anesthesia.
Intense point pain and hypersensitivity to cold was observed in all cases (100%). Two out of 4 patients (50%) presented an irradiation of the pain at the ipsilateral arm and shoulder. Surgical procedure was performed successfully in all cases, with total excision of the tumor and no intraoperative or postoperative complications. No recurrences occurred.
Diagnosis of glomus tumors of the fingers is generally easy when manifested with the classical clinical picture and duplex ultrasonography is employed. Complete surgical excision is curative, providing immediate relief of symptoms and improvement of eventual professional or psychological discomfort.
血管球瘤是起源于皮下血管球装置的罕见肿瘤。它们占上肢软组织肿瘤的1% - 5%，大多数病例发生在甲床。典型的临床表现包括阵发性疼痛和对寒冷过敏，这限制了患手的使用，给患者带来实际、职业上的困扰，且常常造成情绪上的不适。
在过去30年里，我们机构治疗了4例手指血管球瘤患者。3例患者右手有肿瘤（分别在第1、3和4指），1例患者左手有肿瘤（在第2指）。3个肿瘤位于甲床，1个位于指尖。所有病例在术前和术中均采用双功超声检查，以确保肿瘤完全切除。所有患者均在局部阻滞麻醉下接受肿瘤手术切除。
所有病例（100%）均观察到剧烈的点状疼痛和对寒冷过敏。4例患者中有2例（50%）出现同侧手臂和肩部疼痛放射。所有病例手术均成功进行，肿瘤完全切除，无术中或术后并发症。无复发情况发生。
当手指血管球瘤表现出典型临床症状并采用双功超声检查时，其诊断通常较为容易。完整的手术切除可治愈疾病，能立即缓解症状，并改善最终的职业或心理不适。
