PURPOSE OF THE STUDY: Glomus tumors are infrequent in the hand. We have review 55 cases, localized in the nail area to discuss their diagnosis and surgical approach. MATERIAL AND METHODS: Out of 80 glomus tumors of the hand seen in two hand units, 55 were located around the nail area, 33 in the nail bed area, 8 at the 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 cold. A blue spot was visible in 15 cases and diagnosis was performed on clinical ground in all cases except two. A notch was present on X-ray in 16 cases. A prospective study with MRI allow a diagnosis in 18 of 21 cases. All tumors were removed through a lateral approach elevating the nail complex and confirmed histologically. RESULTS: The diagnosis was per-operatively confirmed in 53 cases and performed in one case. The last case of supposed hemangioma was modified at histological examination. No case of nail dystrophy (not existing pre-operatively) or residual pain was seen at the 81 months of follow up. Seven recurrences were observed, 4 of them having been operated initially in our units. DISCUSSION: Clinical diagnosis could be performed on clinical grounds. MRI is to be reserved to recurrences or multi-operated patients. Risk of recurrence has to be mentioned pre-operatively to the patient. CONCLUSION: Lateral approach with nail complex elevation is safe, allowing excision of the tumor without nail dystrophy.

Les tumeurs glomiques de la region ungueale : A propos d'une serie de 55 patients / G. Foucher, D. Le Viet, Z. Dailiana, G. Pajardi. - In: REVUE DE CHIRURGIE ORTHOPEDIQUE ET REPARATRICE DE L'APPAREIL MOTEUR. - ISSN 0035-1040. - 85:4(1999 Jul), pp. 362-366.

Les tumeurs glomiques de la region ungueale : A propos d'une serie de 55 patients

G. Pajardi
Ultimo
1999

Abstract

PURPOSE OF THE STUDY: Glomus tumors are infrequent in the hand. We have review 55 cases, localized in the nail area to discuss their diagnosis and surgical approach. MATERIAL AND METHODS: Out of 80 glomus tumors of the hand seen in two hand units, 55 were located around the nail area, 33 in the nail bed area, 8 at the 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 cold. A blue spot was visible in 15 cases and diagnosis was performed on clinical ground in all cases except two. A notch was present on X-ray in 16 cases. A prospective study with MRI allow a diagnosis in 18 of 21 cases. All tumors were removed through a lateral approach elevating the nail complex and confirmed histologically. RESULTS: The diagnosis was per-operatively confirmed in 53 cases and performed in one case. The last case of supposed hemangioma was modified at histological examination. No case of nail dystrophy (not existing pre-operatively) or residual pain was seen at the 81 months of follow up. Seven recurrences were observed, 4 of them having been operated initially in our units. DISCUSSION: Clinical diagnosis could be performed on clinical grounds. MRI is to be reserved to recurrences or multi-operated patients. Risk of recurrence has to be mentioned pre-operatively to the patient. CONCLUSION: Lateral approach with nail complex elevation is safe, allowing excision of the tumor without nail dystrophy.
Cinquante cinq tumeurs glomiques péri-unguéales, confirmées histologiquement ont été revues rétrospectivement avec un recul moyen de 81 mois. Le diagnostic avait été fait cliniquement dans 53 cas, devant une douleur exacerbée au choc et au froid, élicitée avec une pointe de crayon et améliorée par gonflement d'un garrot brachial. Dans 2 cas le diagnostic d'hémangiome a été fait et redressé à l'intervention dans un cas. L'IRM a été étudiée prospectivement et a conduit au diagnostic 18 fois sur 21. Nous la réservons cependant aux cas récidivés ou multi-opérés. Toutes les tumeurs (sauf les deux pseudo-hémangiomes) ont été abordées par voie latéro-unguéale. Aucune dystrophie unguéale n'est à imputer à cette voie d'abord. Sept récidives ont été observées et doivent conduire à informer les patients en pré-opératoire de cette complication rarement mentionnée.
glomus tumor; vascular; finger; nail apparatus
Settore MED/19 - Chirurgia Plastica
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/442620
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