What Is a Glomus Tumor?

Hemangiomas are a rare benign small hemangioma with few malignant changes. The hemangiomas are normal tissue structures with a diameter of about 1mm. They are located under the reticular layer of the dermis and are common in the fingers, toes, and under the nail bed. Extremity skin or subcutaneous tissue, other parts of the body such as muscles, penis, trunk and internal organs such as stomach, nasal cavity, trachea can also occur. Most are single shots, and multiple shots are rare. Middle-aged and young people are more frequent, and women are slightly more than men.

Basic Information

English name

glomus tumor

Visiting department

Vascular surgery

Multiple groups

female

Common symptoms

Spontaneous intermittent pain, intolerable tenderness, and cold sensitivity to pain

Causes of Hemangiomas

At present, the pathogenesis is not clear, trauma may be its cause, and localized stimuli such as long-term compression, friction, and temperature changes may also be related to its occurrence. Multiple familial hemangiomas are autosomal dominant.

Hemangioma clinical manifestations

Solitary hemangiomas often occur in the finger (toe) and are more common in women. Typical cases grow in the nail bed. The typical clinical "triple sign" is: spontaneous intermittent severe pain, unbearable tenderness and pain. Cold sensitivity. The tumor is small, generally 1 to 2 cm in diameter, and rarely more than 3 cm. Blue, purple-red rice grains can be seen under the nails or under the skin, and they are extremely sensitive. Slight friction or pressure on the pen tip can cause severe pain and spread to the entire limb. Radiation lasts for more than ten minutes to several hours. Patients are protected by hands all day to prevent the onset of pain. If the affected limb is immersed in cold or hot water, the pain can be relieved. During the onset of pain, some patients may also be accompanied by symptoms of ipsilateral sympathetic vascular movement disorders, such as Sweat, chills, and ipsilateral horner syndrome. Subungual hemangiomas have a longer course, and there is also a bone loss near the tumor in the distal phalanx.

Multiple hemangiomas are rare, and most often develop in childhood. They show large blue soft nodules, which are extensive and can be localized. They are mostly without symptoms. A few patients may have both painful and painless skin. damage.

Hemangiomas examination

Physical inspection

The pin compression test (pressing the surface of the tumor with the tail of the pin to cause pain) was positive.

2. Laboratory inspection

Histopathology showed dilated vascular lumen, lined with a single layer of flat endothelial cells, and the endothelial cells were surrounded by several or multiple layers of hemangioblasts. Tumors can have connective tissue, smooth muscle tissue, and myelinated nerve fibers. Under the electron microscope, tumor cells have the characteristics of smooth muscle cells, not epidermal cells. Immunohistochemistry was positive for Vimentin and basement membrane components.

3. Imaging examination

X-ray examination is used to check whether hemangiomas have compressed the phalanges and formed phalanx marks, and can observe whether hemangiomas have hardened cyst-like changes. Magnetic resonance imaging can detect lesions earlier, clearly show the boundaries, accurate positioning, and clearly show its relationship with surrounding tissues, which can help determine the tumor range during surgery.

Hemangiomas diagnosis

Diagnosis of finger (toe) damage with a typical triad is easier. Finger (toe) pain, especially in cases of severe pain caused by cold, local collision and compression, should first consider finger hemangiomas. Combining a positive pin test with X-rays suggests a tumor indentation on the dorsal side of the phalanx to confirm the diagnosis. Hemangiomas outside the nail bed, due to their small size, deep location, and inaccurate positioning, lack the typical triad of hemangiomas, making diagnosis difficult and often misdiagnosing.

Differential diagnosis of hemangiomas

Sub-A hemangiomas should be distinguished from bone warts, fibroids, melanomas, etc. Non-A should be distinguished from neurofibromas and hemangiomas. The main points of identification are that hemangiomas have fixed-point pain and cold sensitivity. Examination revealed that blood vessel cells of uniform size were arranged around the vessel wall.

Multiple hemangiomas need to be distinguished from Blue Rubber Nipple Syndrome (BRBNS). The difference between the two is that the latter is often congenital, and the disease often starts in childhood; BRBNS often affects the gastrointestinal tract, but the disease rarely affects the gastrointestinal tract; histopathological features Sexual hemangioblasts, while BRBNS have no hemangioblasts.

Hemangiomas treatment

Once a hemangiomas with pain are diagnosed, they should be surgically removed. Thorough resection of the tumor is an effective treatment for this disease. Subungual hemangiomas can be performed under digital nerve block anesthesia. Depending on the location of the tumor, some nails are removed, and the nail bed is cut and pulled. You can see the round, intact capsules under the nail bed in pink or Small mauve tumor with clear edges. Healing usually takes about 2 weeks. Multiple hemangiomas do not require special treatment when there is no pain. For those who have obvious pain, laser treatment can be used to reduce the pain. If necessary, the painful skin lesions can be removed by surgery.