Glomus-cell tumors

From dermoscopedia

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 Editor: Luc Thomas

 Author(s): Amélie Boespflug, Luc Thomas
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Description This chapter describes the dermoscopy aspect of subungual glomus cell tumors
Author(s) Luc Thomas · Amélie Boespflug
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Status update June 25, 2018
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Glomus-cell tumors are rare benign harmatomas of the glomus body, a specialized arteriovenous anastomosis located in the stratum reticularis of the dermis that is involved in thermoregulation[1]. They represent 1-5% of soft tissue tumors of the hand [2] and are mostly located in subungual locations even if they can also rarely appear in extra-digital areas.


Clinically they appear in young adults (20-40 years) as small painful reddish subungual tumefactions. Pain is increased by pressure and by exposure to cold temperatures.



Nail plate dermoscopy can reveal the presence a structureless purple or blue spot through the nail plate or may find numerous ramifying vessels within a homogeneous red-blue tumor[3],[4].


Dermoscopic aspect of a glomus-cell tumor Dermoscopic aspect glomus-cell tumor


Dermoscopic aspect of a glomus-cell tumor Per-operative dermoscopic aspect of a glomus-cell tumor


Imaging by MRI can help to precise the localization of the tumor and facilitate the pre-surgical evaluation of their size.

MRI glomus-cell tumor aspect


The treatment of glomus-cell tumors consists of a complete surgical removal of the lesion with histological examination. Intra-operative dermoscopy can help delimitate the tumor for an optimal resection, after anesthetic block, the use of a tourniquet (to avoid excessive bleeding) and careful avulsion of the nail plate.




References

  1. Goldblum JR, Folpe AL, Weiss SW. Perivascular tumours. In: Goldblum JR, Folpe AL, Weiss SW, editors. Enzinger and Weiss’s soft tissue tumours. 6th ed. Philadelphia: Elsevier; 2014. p. 749-65.
  2. Soule EH, Ghormley RK, Bulbulian AH. Primary tumors of the soft tissues of the extremities exclusive of epithelial tumors: an analysis of five hundred consecutive cases. AMA Arch Surg 1955;70:462- 74.
  3. Maehara LS, Ohe EM, Enokihara MY, et al. Diagnosis of glomus tumor by nail bed and matrix dermoscopy. An Bras Dermatol. 2010;85:236-238. 43. Haenssle HA, Blum A, Hofmann-Wellenhof R, et al.
  4. When all you have is a dermatoscope- start looking at the nails. Dermatol Pract Concept. 2014;4:11-20.