Recurring finger discomfort: Case study on Glomus tumor
A 45-year-old male of Maasai origin presented with a 5-year-long pain in the tip of his left ring finger. The patient had attended multiple health facilities, including traditional healers, and was misdiagnosed and treated for gout arthritis. However, upon closer examination, the patient showed sharp tenderness centrally at the nail of the left ring finger, swelling, and a positive Love's pin test, Hildreth's test, and cold test, which led to a different diagnosis.
The case in question involved a glomus tumor, a rare benign growth found primarily in the dermis or subcutaneous tissue. These tumors were first described by Wood in 1812 and later by Hoyer in 1877. Glomus tumors can be found in other locations, such as the lungs, pancreas, stomach, genitourinary tract, and gastrointestinal tract, but are often misdiagnosed.
The diagnostic approach for glomus tumors relies on clinical history and physical examination, focusing on lesion characteristics (color, size, pain, location). Histopathological confirmation is essential, as the tumors show rows of glomus cells around venous channels and specific immunohistochemical staining patterns. Differentiation from other vascular anomalies is critical to avoid misdiagnosis.
In this particular case, initial laboratory investigations revealed a normal leukocyte count, hemoglobin, platelet count, creatinine, and a high uric acid level. An x-ray imaging revealed depressions on the dorsal aspect of the distal phalanx, and magnetic resonance imaging confirmed a glomus tumor measuring 0.3 cm × 0.3 cm × 0.5 cm in size. Histopathology showed perivascular proliferation of homogenous round cells with round-to-ovoid nuclei arranged in multicellular layers around blood vessels.
Complete marginal excision and bone curettage were performed under local anesthesia and with a finger tourniquet. The patient experienced complete symptom resolution with no recurrence during a 2-year follow-up.
It is important to note that there is limited explicit data on the prevalence of glomus tumors in Africa. Given their rarity and benign nature, their epidemiology is not well documented regionally, including Africa. More regional studies or case reports would be needed to clarify prevalence and diagnostic difficulties specific to Africa.
In conclusion, this case report discusses the presentation and diagnostics of a glomus tumor in an African setting, highlighting the need for further research to understand the prevalence and diagnostic challenges of these tumors in African healthcare systems.
- The unique case of a glomus tumor, a rare benign growth often found in the skin, was diagnosed in a 45-year-old male of Maasai origin after being misdiagnosed for gout arthritis.
- Diagnosis of glomus tumors requires careful attention to lesion characteristics, histopathological confirmation, and differentiation from other vascular anomalies to avoid misdiagnosis.
- Magnetic resonance imaging played a critical role in the diagnosis of this patient's glomus tumor, helping to determine its size and location.
- Further research is needed to understand the prevalence and diagnostic challenges associated with glomus tumors in African healthcare systems, as there is currently limited data available on this topic.
