Glomus Tumors in the Foot: Case Series.
Glomus tumors are painful, benign neoplasms that frequently are associated with delayed diagnosis. Commonly in the hand, they rarely present in the foot. The purpose of this case series is to characterize the clinical presentation, radiology, pathology, and surgical outcomes associated with foot glomus tumors. We reviewed our pathology database for patients with foot glomus tumors diagnosed between 1995 and 2013. Medical records including physician notes, pathology, and radiology were reviewed. Eleven patients had foot glomus tumors excised at our institution during the study period. The mean age was 45.4 (range = 28-60) years. One patient was lost to follow-up. Mean follow-up for the remaining 10 patients was 44.7 (range = 3-142) months. Ten tumors were located in the subungual region, while 1 was located in the plantar pulp of the distal phalanx. All patients presented with pain. Point tenderness, cold hypersensitivity, and nail abnormalities were variably documented but frequently present. Four patients had had prior surgery for an ingrown toenail prior to presentation at our institution. Six patients had preoperative magnetic resonance imaging studies, which were diagnostic of glomus tumor in all cases except one. Radiographs failed to provide diagnosis in all 8 patients for whom they were obtained. Postoperatively, all patients had complete symptom relief with no recurrences.In conclusion, this case series demonstrates that foot glomus tumors frequently present with classic symptoms including pain, point tenderness, and cold hypersensitivity. When clinically suspected, magnetic resonance imaging should be obtained. Marginal excision results in symptom relief and cure.


METHODS
Therapeutic, Level IV: Case series.
Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York.
Samir K
SK
Trehan
Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York.
Dylan S
DS
Soukup
Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York.
Douglas N
DN
Mintz
Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York.
Giorgio
G
Perino
Orthopaedic Residency Program (SKT), Hospital for Special Surgery, New YorkDepartment of Foot and Ankle Surgery (DSS, SJE), Hospital for Special Surgery, New YorkDepartment of Radiology and Imaging (DNM), Hospital for Special Surgery, New YorkDepartment of Pathology and Laboratory Medicine (GP), Hospital for Special Surgery, New York elliss@hss.edu.
Scott J
SJ
Ellis
D000328:Adult; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery; D056587:Cryopyrin-Associated Periodic Syndromes / Q000209:etiology; D005260:Female; D005528:Foot / Q000601:surgery*; D005918:Glomus Tumor / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000601:surgery*; D009264:Nails, Malformed / Q000209:etiology; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000601:surgery*
MRI; foot tumor; glomus tumor; toe mass