Glomus tumor of the nail area. A series of 55 cases

Purpose of the study Glomus tumors are unfrequent in the hand. We have revi ew 55 cases, localized in the nail area to discuss their diagnosis and surg ical approach. Material and methods Out of 80 glomus tumors of the hand seen in two hand u nits, 55 were located around the nail area, 33 in the nail bed area, 8 at t he nail root and 14 laterally. The population was predominantly female (42 cases) and the mean age 43 years. The mean delay before presentation was 37 months. Pain was the main symptom (97 per cent) increased by trauma and co ld. A blue spot was visible in 15 cases and diagnosis was performed on clin ical ground in all cases except two. A notch was present on X-ray in 16 cas es. A prospective study with MRI allow a diagnosis in 18 of 21 cases. All t umors were removed through a lateral approach elevating the nail complex an d confirmed histologically. Results The diagnosis was per-operatively confirmed in 53 cases and perform ed in one case. The last case of supposed hemangioma was modified at histol ogical examination. No case of nail dystrophy (not existing pre-operatively ) or residual pain was seen at the 81 months of follow up. Seven recurrence s were observed, 4 of them having been operated initially in our units. Discussion Clinical diagnosis could be performed on clinical grounds. MRI i s to be reserved to recurrences or multi-operated patients. Risk of recurre nce has to be mentionned pre-operatively to the patient. Conclusion Lateral approach with nail complex elevation is safe, allowing e xcision of the tumor without nail dystrophy.