Glomus Tumors: A Review of Preoperative Magnetic Resonance Imaging to Detect Satellite Lesions

摘要

Glomus tumors are malformations of the neuromyoarterial system that commonly develop in the digits and cause exquisite tenderness, especially with cold temperatures. Treatment typically involves surgical excision, although there is a tendency to avoid aggressive resections, which may lead to aesthetically displeasing nail plate deformities. In a minority of patients, symptoms may persist and the tumor may recur. The etiology of the persistent of symptoms is debatable. One theory for the persistence of symptoms is an incomplete initial excision of the glomus tumor. Another theory suggests that clinically unapparent satellite lesions exist at the time of diagnosis that are not excised, and they later mature into symptomatic recurrent tumors. Although not clinically visible, if present, these satellite lesions should be seen on preoperative magnetic resonance imaging. The authors reviewed all cases of pathology-confirmed glomus tumors in the past 7 years at a single institution in which preoperative magnetic resonance imaging using a high-powered 3.0 Tesla (General Electric, Buckinghamshire, United Kingdom) magnet was performed. Six cases met inclusion criteria and only 1 case developed a recurrent glomus tumor. None of the cases were found to have satellite lesions associated with the primary glomus tumor on magnetic resonance imaging. Preventing recurrence seems to be dependent on the completeness of the initial excision. Preoperative magnetic resonance imaging is a valuable tool used to delineate the extent of the tumor for surgical planning.