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Intravascular Glomus Tumor of the Forearm Causing Chronic Pain and Focal Tenderness

DOI: 10.1155/2014/619490

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Abstract:

Introduction. A glomus tumor is a benign vascular tumor derived from glomus cells and occurs mainly in the subcutaneous layer of the subungual or digital pulp. Extradigital glomus tumors have been reported within the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery. Glomus tumors can originate from the intraosseous, intramuscular, periosteal, intravascular, and intraneural layers. However, a glomus tumor originating from the intravascular layer of the forearm is a rare condition. Case Report. A 44-year-old woman had a 7-year history of chronic pain and focal tenderness of the forearm. No hypersensitivity or sensory alterations were observed. Contrast magnetic resonance imaging (MRI) showed a mass measuring 5 × 3 × 2?mm leading to a vein. Surgical excision was performed, and the tumor was completely resected. Finding of gross examination revealed a dark-red, well-defined soft tissue tumor, and histologic examination confirmed that the mass was a glomus tumor. The patient’s symptoms were completely resolved postoperatively. Conclusion. Intravascular glomus tumors rarely occur in the forearm; therefore, a thorough physical exam, comprehensive medical history, in-depth imaging, and early surgical excision upon clinical suspicion may be helpful to prevent a delayed or incorrect diagnosis. 1. Introduction The normal glomus body is a specialized arteriovenous anastomosis that plays a role in thermoregulation [1]. A glomus tumor is a benign type of vascular neoplasm composed of modified smooth muscle cells and is thought to originate from the glomus body within reticular dermis [2]. Glomus tumors are most frequently found in the extremities, usually on the digits [3]. They are also located on extradigital sites, including the palm, wrist, forearm, foot, bone, stomach, colon, cervix, and mesentery [4]. Various origins of glomus tumors have been reported, including intramuscular, periosteal, intraosseous, intravascular, and intraneural locations [3, 5]. Although the forearm is the most common extradigital location [3], intravascular origination of a forearm glomus tumor is an exceptionally rare occurrence. To the best of our knowledge, only 3 cases of intravascular forearm glomus tumors have been reported [1, 6, 7]. Here, we present a rare case of a patient with chronic pain and focal tenderness caused by an intravascular glomus tumor in the forearm. 2. Case Report A 44-year-old woman presented with a 7-year history of occasional pain on the volar-radial aspect of her right mid-forearm. The patient reported that the pain had gradually

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