1/7. Supraclavicular glomus tumor, 20 year history of undiagnosed shoulder pain: a case report.A long-standing case of severe dysesthesia due to a supraclavicular glomus tumor is presented. chronic pain caused by a subcutaneous glomus (non-chemodectoma) tumor is rare and usually misdiagnosed. The supraclavicular location, presentation, and coincidence of trauma history are unique in this case. A 62-year-old male complained of 20 years of intractable right shoulder and supraclavicular region pain, which started 6 months after a fall. The pain was unrelieved by repeated and extensive physical therapy, chiropractic manipulation, local steroid injections, and two shoulder operations. The cause of the condition remained undiagnosed and obscure. Local surgical exploration revealed a subcutaneous grayish mass with pathologically proven glomus tumor. Immediate alleviation of the pain and tenderness followed complete resection of the mass. The patient remained free of pain at a 2-year follow-up. Subcutaneous glomus (non-chemodectoma) tumors can occur in unusual sites, and should be considered in chronic regional pain syndromes. Immediate cure is generally achieved by local resection. Pertinent literature is reviewed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/7. upper extremity pain of 10 years duration caused by a glomus tumor.BACKGROUND AND OBJECTIVES: Long-standing limb pain typically has a multifactorial etiology not amenable to causal therapy. We present a case of chronic progressing upper extremity pain caused by a glomus tumor; the excision was curative. methods: A 39-year-old woman presented with 10-year history of constant deep internal throbbing, aching pain localized to the radial aspect of the left index finger and additional intermittent shooting pains radiating up the arm toward the shoulder. Pain was increased after minor local trauma, following cold exposure, and for unknown reasons. A blotchy, bluish skin discoloration could appear on the radial aspect of the index finger during severe pain. Nonsteroidal antinflammatory drugs, narcotics, amitriptyline, local heat, bracing, and a sympathetic nerve block had all been ineffective. The physical examination was characterized by exquisite pressure tenderness over the radial aspect of the left index finger, most pronounced just distal to the distal interphalengeal joint. RESULTS: Inflation of a left arm blood pressure cuff to above systolic pressures abolished pain. A glomus tumor was suspected and confirmed by histologic examination. CONCLUSIONS: Glomus tumors are rare, benign neoplasms (1 to 5% of all hand tumors), developing from neuromyoarterial glomus bodies. They usually present with pain and may mimic other painful conditions, delaying the average time until diagnosis for up to 10 years. The classic diagnostic triad consists of local pain, pressure tenderness, and cold hypersensitivity. Abolition of pain following inflation of a blood pressure cuff to above systolic levels (ischemia test) is highly diagnostic. We suggest routine use of this test in cases of upper limb pain of unclear etiology.- - - - - - - - - - ranking = 24.709408284024keywords = physical examination, physical (Clic here for more details about this article) |
3/7. Sonographic findings in glomus tympanicum tumor.A glomus tympanicum tumor that is associated with a visible retrotympanic mass is the most frequent cause of pulsatile tinnitus. The preoperative diagnostic approach to this lesion includes a meticulous physical examination as well as high-resolution CT, magnetic resonance angiography, and digital angiography, which can also be used for preoperative embolization. We report the use of color transcranial Doppler sonography in the evaluation of glomus tympanicum tumor in a 67-year-old woman with a 3-year history of left tinnitus. An otoscopic examination revealed a reddish pulsatile mass behind an intact tympanic membrane. No lesions were visualized on gray-scale sonography. Contrast-enhanced color transcranial Doppler sonography showed a vascular ovoid mass that measured 2 x 1 x 1 cm; spectral analysis of the lesion revealed arterial flow with a low resistance index. color transcranial Doppler sonography helped define the dimensions and vascular characteristics of the lesion.- - - - - - - - - - ranking = 24.709408284024keywords = physical examination, physical (Clic here for more details about this article) |
4/7. Glomangioma of the hip.BACKGROUND: Glomus tumors may occur in any region of the body, but they are very rare in the hip. OBJECTIVE: To present the eighth reported case of a glomus tumor of the hip up to date. methods: This is a case report and a literature review. RESULTS: A 68-year-old man presented with severe pain and tenderness in the right hip, especially on palpation and in the sitting position. On physical examination, there was a soft palpable subcutaneous mass and severe tenderness in the right hip. Ultrasound revealed a hypervascular subdermal mass that was 2 cm in diameter. The lesion arose from the dermis and extended into the subcutaneous tissue. It was totally excised under local anesthesia. The histopathologic diagnosis was a glomangioma. The patient has been symptom free in the 2 months of follow-up. CONCLUSIONS: Glomus tumors should be kept in mind in the differential diagnosis of painful subdermal mass. Surgical excision of the lesion with a sufficient margin of surrounding normal tissue not only achieves the exact diagnosis but also results in adequate treatment. In case of the presence of malignant features, a wide excision is needed with a close follow-up of patient for regional or distant metastases.- - - - - - - - - - ranking = 24.709408284024keywords = physical examination, physical (Clic here for more details about this article) |
5/7. Recurrent epistaxis from an intranasal glomus tumor: the 22nd case report.The case of a 66-year-old Thai woman who was treated at King Chulalongkorn Memorial Hospital due to recurrent epistaxis for two years is presented. Her physical examination revealed a 0.7-cm tumor mass on the right nasal septum. A biopsy was subsequently done and the tissue was sent for pathological examination. The lesion was then diagnosed as "glomus tumor of the nasal septum". Histologically, the tumor was rather well-circumscribed and located in the submucosal region. The neoplastic cells were uniform, round to ovoid in shape and contained bland-looking, finely chromatic nuclei and moderate amount of cytoplasm with ill-defined cell borders. These cells were intervened by tortuous vascular structures. Immunohistochemically, the tumor cells were strongly reactive to smooth muscle actin and negative to cytokeratin and S-100 protein. A glomus tumor is rare in the sinonasal region. So far, there have been only 21 reported cases in the literature. Almost all cases of sinonasal glomus tumor are benign and are usually cured by complete excision.- - - - - - - - - - ranking = 24.709408284024keywords = physical examination, physical (Clic here for more details about this article) |
6/7. glomus tumor of the musculotendinous junction of the rotator cuff. A case report.A rare case of glomus tumor of the rotator cuff is presented. A 35-year-old man had a 20-year history of left shoulder pain. Through physical examination, muscular atrophy in the supraspinatus and infraspinatus muscles and restriction of shoulder motion was seen. magnetic resonance imaging showed an abnormal oval shadow in the supraspinatus musculotendinous junction, and postcontrast computed tomographic scanning showed a small calcification focus in the tumor. Surgical excision of the tumor and rotator cuff reconstruction using Debeyre's procedure were done. Microscopic examination of the tumor showed a typical glomus tumor. It was difficult to diagnose glomus tumor in this patient before surgical intervention. Retrospective consideration indicated that the history of the present illness, computed tomographic scanning, and magnetic resonance imaging were critical for differential diagnosis.- - - - - - - - - - ranking = 24.709408284024keywords = physical examination, physical (Clic here for more details about this article) |
7/7. A 63-year-old woman with right small finger pain.The following case is presented to illustrate the clinical findings and imaging modalities of a condition of interest to the orthopedic/hand surgeon. The initial history, physical examination, and imaging examinations are found on this page. The final clinical and roentgenographic differential diagnosis and discussion can be found on the following pages.- - - - - - - - - - ranking = 24.709408284024keywords = physical examination, physical (Clic here for more details about this article) |