Clinical Spectrum and Surgical Management of Hand Glomus Tumors: A Case Series of Five Histopathologically Confirmed Cases

Abstract

Background: Glomus tumors are rare benign neoplasms arising from the glomus body and most commonly occur in the subungual region of the digits. Despite their small size, they characteristically cause severe localized pain, point tenderness, and cold hypersensitivity, often resulting in delayed diagnosis. This case series describes the clinical presentation, anatomical distribution, diagnostic evaluation, surgical management, and outcomes of five histopathologically confirmed glomus tumors of the hand. Case Series: We retrospectively reviewed five consecutive patients with histopathologically confirmed glomus tumors who underwent surgical excision at a tertiary care center. The patients included three women and two men, aged 34–49 years. Three tumors were subungual, involving the right thumb, left thumb, and right little finger; one involved the fingertip pulp of the right ring finger; and one was located on the dorsum of the right hand. Patients presented with chronic localized pain, with cold hypersensitivity and point tenderness documented in the clinically typical lesions. Imaging was performed selectively for lesion localization. Complete surgical excision was achieved in all cases through an approach tailored to the anatomical location, including transungual, direct pulp, and dorsal approaches. Histopathological examination confirmed glomus tumor in all five cases. During follow-up, all patients reported complete resolution of pain, with no documented recurrence or significant post-operative nail deformity. Conclusion: Glomus tumors should be considered in patients presenting with persistent, localized digital pain, particularly when associated with point tenderness and cold hypersensitivity. Although the subungual region is the most common site, lesions may occur in atypical locations such as the fingertip pulp and dorsum of the hand. Careful clinical assessment, appropriate imaging when indicated, complete surgical excision, and histopathological confirmation are essential for accurate diagnosis and effective treatment. Early recognition may reduce diagnostic delay and facilitate excellent symptomatic outcomes.