Clinical observation of microscopic resection of glomus tumor in 38 cases
Objective To observe the clinical characteristics of glomus tumor and to investigate the microscopic surgical outcomes.Methods The clinical data of 38 patients with glomus tumor receiving microscopic resection in the First Affiliated Hospital of Henan University of Science and Technology from January 2016 to December 2021 were retrospectively analyzed.The clinical signs,results of pain tests before surgery,size and location of glomus tumor,singular or multiple,bone compression or local depression of phalanges,and postoperative histopathological examination results were recorded.The subungual glomus tumor was separated from the nail bed under microscope.The tumor was adequately exposed and resected completely after layer-by-layer separation under microscope if it was located in the finger pulp or knee joint.The incision was closed by using collagen sutures,followed by incision coverage with a single layer of Vaseline gauze.The wound healing enhancer was sprayed on the nail bed to promote wound healing.The patients were followed up for 1 year to record pain relief and tumor recurrence,and the fingernail/toenail growth was observed in patients with subungual glomus tumor.Results(1)Severe pain was the main complaint of 38 patients,presenting as needle-like or burning sensation,which aggravated when exposed to cold or heat.The surface projection sites of all tumors had severe tender spots,some subungual glomus tumors exhibited faint purple changes at their surface projection sites,and all pain tests yielded positive results.(2)The diameter of the tumor ranged from 1.7 to 12.6 mm.The tumors were located in the finger pulp in 9 patients,subcutaneously at the knee joint in 1,beneath the left hallux toenail in 1,symmetrically involving both ring fingers in 1,multiple lesions(2 lesions)beneath the right fingernail in 1,and single lesion beneath the fingernail in 25(one patient had a history of trauma at the affected site).All subungual glomus tumors compressed the terminal phalanges,causing local phalanges depression under the tumors.Postoperative histopathologic findings confirmed all glomus tumors.(3)All 38 patients had primary wound healing 2 weeks after discharge.The follow-up till January 2023 showed the disappearing of pain symptoms and no recurrence or significant complications.In patients with subungual glomus tumor,the nails grew well,exhibiting a smooth and even surface without splitting or jagged edges.Conclusion Microscopic resection of glomus tumor achieves a good result,with minimal damage to the nail bed,while the collagen sutures and wound healing enhancer contribute to the healing of the incision.
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