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Glomus tumours of the foot and ankle: case report of a rare disease and review of the literature

Authors


Dr med. B_thomann Department of Orthopaedic Surgery, Regionalspital, CH-3400 Burgdorf, Switzerland.

Abstract

Glomus tumours are described as hamartomas of the normal glomus tissue. They occur mostly as solitary, seldom as multiple, lesions. If there are multiple tumours a generalized type is distinguished from a localized one. In solitary lesions and also in the generalized type of disease history and clinical presentation are typical in most cases and diagnosis is rarely missed. By contrast, diagnosis is often missed in the localized type of disease because (1) it is a rare disease; (2) the clinical appearance is diverse; (3) the lesions are seldom found in the skin and lie more often in deeper layers; and (4) diagnosis is even more difficult when the disease occurs in an unusual area such as the foot and ankle. If a patient suffers from a disease of the lower limb or foot of unknown origin the following clinical facts should be considered as possibly being multiple glomus tumours (MGT): severe circumscribed pain at rest which is increased by walking, high sensitivity to the touch, and irradiation of pain to the foot but also to the thigh. Objective signs consist of hypotrophy of muscles and limb shortening, but no neurological deficiencies are present. There are no visible or palpable tumours. Diagnosis is made by the clinical appearance or by magnetic resonance imaging (MRI). Therapy consists of marginal resection of the lesions, which leads to immediate pain relief. Recurrence frequently occurs. We present a case of localization of the disease within the lower leg, the foot and the ankle and compare it with previously reported cases.

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