Arch Hand Microsurg.  2024 Sep;29(3):191-195. 10.12790/ahm.24.0024.

Glomus tumor of the forearm with unusual intraoperative features: a case report

• Sung K
• Park H
• Lee SH
• Jeong C
• Lee S
• Oh HY
• Lee SY

• KMID: 2558744
• DOI: http://doi.org/10.12790/ahm.24.0024

Abstract

Glomus tumors (GTs) are rare benign vascular neoplasms that predominantly occur in the subungual region of the digits. However, these neoplasms have also been reported in other anatomical locations. Extradigital GTs often present in atypical locations with unconventional symptoms, posing potential diagnostic challenges for clinicians. Herein, we present a recent case of an extradigital GT found in the forearm of a 76-yearold male patient that exhibited intraoperative features similar to those of a nerve sheath tumor or intravascular tumor, further underscoring these diagnostic challenges. This report highlights the pivotal role of frozen section pathology in diagnosing and managing this atypical lesion, thereby facilitating optimal patient care.

Keyword

Forearm; Glomus tumor; Neurilemmoma; Pathology; Schwannoma

Figure

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  Fig. 1. Clinical and operative features. (A) A 1.2-cm subcutaneous nodule on the ulnovolar aspect of the left forearm (arrow). (B) A bluish-red, round-shaped tumor with tubular structures extending from both ends. (C) A lateral aspect of the resected lesion showing a tubular structure (white arrows) attached to the tumor’s undersurface and connected to both stalks (yellow arrows).

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  Fig. 2. Preoperative magnetic resonance images of the left forearm. (A) T1-weighted axial image showing a low-intensity well-defined mass. (B) T1-weighted axial image with contrast, showing strong enhancement.

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  Fig. 3. Histopathological features. (A) An encapsulated tumor containing solid sheets of blue cells (H&E stain, ×15). (B) Round to oval glomus tumor cells with slit-like vascular spaces (H&E stain, ×400). (C) Glomus tumor cells positive for smooth muscle actin immunostaining (×100).

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  Fig. 4. Histopathological features. (A) A sectional view of the tubular stalk (red arrow) attached to the distal portion of the tumor (yellow arrow), showing the blood vessel (H&E stain, ×15). (B) A luminal space on the undersurface of the tumor, suggesting a compressed blood vessel (asterisk; H&E stain, ×100). (C) A luminal space on the undersurface of the tumor has endothelial cells (asterisk), which are positive for CD31 immunostaining (×200).

Reference

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