Balaram Ajay K, Hsu Andrew R, Rapp Timothy B, Mehta Vikas, Bindra Randip R
Hand to Shoulder Associates, Arlington Heights, IL.
Am J Orthop (Belle Mead NJ). 2014 Dec;43(12):567-70.
Glomus tumors are neuromyoarterial glomus body neoplasms that most commonly occur in the subungual areas of the hand. These tumors typically present as painful solitary lesions with localized tenderness. Extradigital glomus tumors are rare and difficult to diagnose because of their varying symptoms and presentation. Misdiagnosis can result in significant chronic pain, disuse syndromes, and disability over prolonged periods. Timely diagnosis and surgical resection are generally curative with complete resolution of symptoms. Surgeons should be aware of this rare condition and consider it in the differential diagnosis when treating a painful soft-tissue mass of the wrist. We report a case of a large solitary glomus tumor that occurred on the volar-radial aspect of the wrist and involved the radial artery. The patient was successfully treated with complete surgical excision of the tumor. There were no symptoms or recurrence at 3-year follow-up. In the literature, this is the first case of large atypical wrist glomus tumor involving the radial artery to be reported with corresponding magnetic resonance imaging, intraoperative, histology, and immunohistochemistry findings.
血管球瘤是神经肌动脉血管球瘤,最常见于手部指甲下区域。这些肿瘤通常表现为疼痛性孤立性病变,伴有局部压痛。指外血管球瘤罕见,由于其症状和表现各异,难以诊断。误诊可导致长期严重的慢性疼痛、废用综合征和残疾。及时诊断和手术切除通常可治愈,症状完全缓解。外科医生应了解这种罕见疾病,并在治疗腕部疼痛性软组织肿块时将其纳入鉴别诊断。我们报告一例发生在腕部掌桡侧并累及桡动脉的大型孤立性血管球瘤病例。患者通过肿瘤完全手术切除成功治愈。3年随访时无任何症状或复发。在文献中,这是首例报告的累及桡动脉的大型非典型腕部血管球瘤,并伴有相应的磁共振成像、术中、组织学和免疫组化结果。