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Extradigital Glomus Tumoers of the Upper Extremity: Systematic Review of Atypical Tumor Presentations Proximal to the Hand
Vikas S. Kotha, M.D., Elad Fraiman, Dennis Kao MD Grzegorz J. Kwiecien, M.D
Cleveland Clinic
2025-01-10
Presenter: Elad Fraiman
Affidavit:
Elad Fraiman
Director Name: Raymond Isakov
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Introduction and Objective
Extradigital glomus tumors, rare neoplasms found primarily in digits, present significant diagnostic challenges when occurring in upper extremities, often leading to misdiagnoses and delayed treatment. Characterized by symptoms like pinpoint pain and cold sensitivity, they mimic other vascular or neural pathologies. This study aims to elucidate the diagnostic intricacies of extradigital glomus tumors.
Methodology
A systematic review was conducted using PubMed and Google Scholar, focusing on literature up to April 1, 2023. We included 37 studies, primarily case reports and retrospective reviews, emphasizing English-language articles on extradigital glomus tumors in the upper extremity.
Results
The total sample size was 136, with the average symptom duration before treatment or diagnosis being nearly six years. The studies revealed a high rate of misdiagnosis, with the two largest studies showing misdiagnosis rates of 48% and 84%. Common symptoms included pinpoint tenderness (86%) and pain (70%). Additional symptoms like painful swelling, hand clumsiness, and night-time pain were reported. Diagnostic imaging varied; MRI was the most common modality. Immunoreactivity studies predominantly showed SMA positivity (81.25%).
Conclusion
Extradigital glomus tumors are more prevalent than previously recognized, with a significant likelihood of misdiagnosis. This misidentification often leads to prolonged patient suffering. While imaging is helpful, it frequently falls short in specific diagnosis, highlighting the importance of clinical suspicion and thorough diagnostic approaches. Our study underscores the need for greater awareness and a multidisciplinary strategy in diagnosing and treating extradigital glomus tumors.
