Department of Neurosurgery, University of Padua - Padua, Italy.
Department of Peripheral Nerve Surgery, Ospedale Civile degli Infermi - Faenza, Ravenna, Italy.
Neurol Res. 2023 May;45(5):435-439. doi: 10.1080/01616412.2022.2151163. Epub 2023 Jan 22.
Peripheral nerve glomus tumors are extremely rare and occur with typical symptoms of peripheral neuropathic pain. Clinicians hardly consider this entity when faced with the swelling of a peripheral nerve and the diagnosis is reached only with histological examination. Nerves of limbs are usually affected and the solid glomus tumor is the most frequent histological variant.
A 55-year-old man presented with a glomus tumor of the anterior supraclavicular nerve of the left cervical plexus, misdiagnosed clinically and radiologically as neuroma. Despite the preoperative suspicion and the intraoperative appearance, the histological examination revealed a glomus tumor with a prevalent muscular component, a glomangiomyoma. Once the tumor was removed, pain regressed completely.
Because of its rarity, pre-operative diagnosis of glomus tumors is still a challenge, especially when arising from peripheral nerves. In the presence of chronic localized neuroma-type pain and sensitivity, glomus tumors should be considered in the pool of differential diagnosis, even if the imaging is not conclusive.
周围神经球瘤极其罕见，其表现为典型的周围神经性疼痛。当遇到周围神经肿胀时，临床医生几乎不会考虑到这种疾病，只有通过组织学检查才能做出诊断。四肢神经通常会受到影响，实性球瘤是最常见的组织学变异型。
一名 55 岁男性出现左侧颈丛前锁骨上神经的球瘤，临床和影像学上误诊为神经瘤。尽管术前怀疑和术中表现提示，但组织学检查显示以肌肉成分为主的球瘤，即血管平滑肌脂肪瘤。肿瘤切除后，疼痛完全消退。
由于其罕见性，球瘤的术前诊断仍然具有挑战性，特别是当起源于周围神经时。在存在慢性局部神经瘤样疼痛和敏感性的情况下，即使影像学检查不明确，也应考虑将球瘤纳入鉴别诊断中。
