Olmos Manuel Ignacio, Johnston Tyler Robert, Gonzalez Jean-François, Camuzard Olivier, Gauci Marc-Olivier
Institut Universitaire Locomoteur et du Sport (IULS), Unité de Recherche Clinique Côte d'Azur (UR2CA), CHU de Nice, Université Côte d'Azur (UCA), Nice, France.
Shoulder Elbow. 2023 Feb;15(1):61-64. doi: 10.1177/17585732211040160. Epub 2021 Oct 20.
Glomus tumors, also known as benign acral tumors are extremely rare. Previous glomus tumors from other regions of the body have been linked to neurological compression symptoms, however axillary compression at the scapular neck has never been described.
Here, we report a case of axillary nerve compression in a 47-year-old man, secondary to a glomus tumor of the neck of the right scapula, initially misdiagnosed with biceps tenodesis performed and no pain improvement. The magnetic resonance imaging demonstrated a well-contoured, 12 mm tumefaction at the inferior pole of the scapular neck T2-hyperintense and T1-isointense and interpreted as a neuroma. An axillary approach allowed the dissection of the axillary nerve, and the tumor was completely removed. The pathological anatomical analysis resulted in a nodular red lesion measuring 14 × 10 mm, delimited and encapsulated with a definitive diagnostic of glomus tumor. The neurologic symptoms and pain disappeared 3 weeks after surgery and the patient reported satisfaction with the surgical procedure. After 3 months, the results remain stable with a complete resolution of the symptoms.
In cases of unexplained and atypical pain in the axillary area, and to avoid potential misdiagnoses and inappropriate treatments, an in-depth exploration for a compressive tumor should be performed as a differential diagnosis.
血管球瘤,也称为良性肢端肿瘤,极为罕见。此前身体其他部位的血管球瘤已被证实与神经压迫症状有关,然而肩胛颈处的腋窝压迫此前从未有过相关描述。
在此,我们报告一例47岁男性因右肩胛颈血管球瘤继发腋神经受压的病例,该患者最初被误诊为肱二头肌固定术且疼痛未改善。磁共振成像显示在肩胛颈下极有一个轮廓清晰、大小为12毫米的肿物,T2加权像呈高信号,T1加权像呈等信号,初步诊断为神经瘤。采用腋窝入路对腋神经进行解剖,并将肿瘤完全切除。病理解剖分析显示一个大小为14×10毫米的结节状红色病变,界限清晰且有包膜,最终确诊为血管球瘤。术后3周神经症状和疼痛消失,患者对手术效果表示满意。3个月后,症状完全缓解,结果保持稳定。
对于腋窝区域不明原因的非典型疼痛病例,为避免潜在的误诊和不恰当治疗,应进行深入检查以鉴别是否存在压迫性肿瘤。