Akechi Yuji, Miura Shiroh, Ochi Masayuki, Enoki Moe, Matsuda Takuya, Kitazawa Riko, Fujibuchi Taketsugu, Ochi Hirofumi, Igase Michiya, Ohyagi Yasumasa
Department of Neurology and Geriatric Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan.
J Med Case Rep. 2021 Jan 13;15(1):8. doi: 10.1186/s13256-020-02616-1.
Glomus tumors are soft tissue neoplasms comprised of glomus cells, vasculature, and smooth muscle cells, which occur commonly in a single subungual area of the digits, and their main clinical features include severe paroxysmal pain, localized tenderness, and cold hypersensitivity.
A 47-year-old Japanese man had suffered from chronic progressive paroxysmal shooting pain in his right leg since childhood. He avoided putting weight on his right foot whenever he walked. The frequency of paroxysmal pain and the number of tender points both gradually increased with age, and his right leg gradually atrophied. Magnetic resonance imaging of the lower extremity demonstrated multiple gadolinium-enhanced nodules that corresponded with his tender points. Excisional biopsy relieved his pain and provided a histopathological diagnosis of glomus tumors.
This case suggests that small glomus tumors located in deep tissue may cause disuse atrophy because of their long delay before diagnosis. Clinicians should consider the potential for glomus tumors when patients exhibit unilateral lower limb muscular atrophy with pain.
血管球瘤是由血管球细胞、脉管系统和平滑肌细胞组成的软组织肿瘤，常见于手指的单个甲下区域，其主要临床特征包括严重的阵发性疼痛、局部压痛和冷过敏。
一名47岁的日本男性自幼患有右下肢慢性进行性阵发性刺痛。他走路时尽量避免用右脚负重。阵发性疼痛的频率和压痛点的数量均随年龄逐渐增加，且其右腿逐渐萎缩。下肢磁共振成像显示多个钆增强结节，与他的压痛点相对应。切除活检缓解了他的疼痛，并提供了血管球瘤的组织病理学诊断。
该病例表明，位于深部组织的小血管球瘤可能因其诊断前的长期延误而导致废用性萎缩。当患者表现为单侧下肢肌肉萎缩伴疼痛时，临床医生应考虑血管球瘤的可能性。
