Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No. 1 Shuaifuyuan Rd, Beijing, 100730, China.
School of Basic Medicine, Fourth Military Medical University, No. 169 Changle West Rd, Xi'an, 710032, China.
BMC Surg. 2022 Mar 16;22(1):97. doi: 10.1186/s12893-022-01545-8.
Glomus tumors commonly affect the extremities, especially subungual. And glomus tumors rarely occur around knee, which are often misdiagnosed. A lack of experience with glomus tumors is likely the cause.
A 42-year-old female presented with continuous dull pain of right knee for the past 7 years. Severe pain was experienced after walking a few hundred meters or climbing up or down stairs. The patient had a slight limp, and the lateral superior aspect of her right knee was tender to palpation. The range of motion and skin around her right knee were normal. Magnetic resonance imaging revealed a well-defined abnormal lesion confluent with the periosteum on the femoral lateral supracondylar. She was finally diagnosed with glomus tumor according to pathological results. After surgery, the pain disappeared, and the patient was discharged three days postoperatively. At the 18-month follow-up visit, the patient reported sustained pain relief, and regular follow-ups were continued. Additionally, 30 published reports documenting 36 cases of glomus tumors around the knee were reviewed, which showed that 20% of all reported cases of glomus tumor around the knee had a history of trauma. The median age for male with glomus tumor was greater than that of female; however, the median duration of illness between the two groups was equivalent. The mean diameters of glomus tumors ranged from 4 to 65 mm, and locations around the knee included the knee joint cavity, soft tissue (e.g. popliteal fossa, patellar tendon, iliotibial band, and Hoffa's fat pad), distal femur, and proximal tibia.
Literature review demonstrated that no significant differences were found between male and female with glomus tumor in regard to location (left or right side) and illness duration. It was noting that a history of trauma may be a cause of glomus tumor and approximate 94.4% of glomus tumors was benign. The most effective therapy accepted for glomus tumors is complete surgical excision, and recurrence was rare after complete surgical excision.
血管球瘤常见于四肢,尤其是甲下。而发生于膝关节周围的血管球瘤较少见,常被误诊。对血管球瘤缺乏认识可能是误诊的主要原因。
一名 42 岁女性,右膝持续钝痛 7 年。行走数百米或上下楼梯时疼痛加重。患者有轻度跛行,右膝外侧上方压痛。右膝活动度及皮肤正常。磁共振成像显示股骨外髁上侧有一界限清楚的异常病变与骨膜融合。根据病理结果,最终诊断为血管球瘤。手术后疼痛消失,术后 3 天出院。术后 18 个月随访,患者诉疼痛持续缓解,定期随访。此外,回顾了 36 例膝关节周围血管球瘤的 30 篇已发表文献,其中 20%的膝关节周围血管球瘤有外伤史。男性血管球瘤的中位年龄大于女性,但两组的中位病程相当。血管球瘤的平均直径为 4 至 65mm,膝关节周围的位置包括膝关节腔、软组织(如腘窝、髌腱、髂胫束和髌下脂肪垫)、股骨远端和胫骨近端。
文献复习表明,血管球瘤患者的性别、病变侧别和病程无显著差异。值得注意的是,外伤史可能是血管球瘤的病因之一,约 94.4%的血管球瘤为良性。血管球瘤的最有效治疗方法是完全手术切除,完全切除后复发罕见。