Novel Transungual Approach Using a Cement Spacer for a Recurrent Intramedullary Glomus Tumour of the Finger: A Case Report

TL;DR

This case report describes a rare recurrent finger tumor treated with a new surgical method involving a cement spacer to support the finger after tumor removal.

Contribution

A novel transungual surgical approach with a cement spacer is introduced for treating recurrent intramedullary glomus tumors.

Findings

The tumor recurred despite multiple surgical excisions, indicating incomplete removal or an undiagnosed tumor.

The novel approach with a cement spacer provided structural support and improved surgical outcomes.

Early diagnosis and complete excision are critical for effective treatment of glomus tumors.

Abstract

Glomus tumours are rare benign epithelial and mesenchymal neoplasms of the glomus body, which primarily occur in the subungual area of fingers, characterized by excruciating pain, point tenderness, and cold sensitivity. Glomus tumours are also reported to be extradigital in almost every organ, which makes them difficult to diagnose due to their rarity. Delayed diagnosis commonly happens due to negative imaging from plain radiograph and ultrasound imaging. Early recognition of this disease with proper diagnosis and complete surgical excision is typically effective, leading to resolution of symptoms. Despite there is a chance of recurrence even with surgical excision in some cases, probably due to incomplete excision or the presence of another undiagnosed tumour at the beginning. We present a rare case of a recurrent intramedullary glomus tumour of the finger that persisted despite multiple surgical excisions. This case was managed using a novel transungual surgical approach, incorporating a cement spacer to provide structural support for the finger pulp following the removal of the diseased distal phalanx. We also review the surgical outcomes in this challenging scenario.

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