Unrelenting discomfort in fingers: A case study on Glomus tumors
A 45-year-old male of Maasai origin presented with a persistent pain in the tip of his left ring finger for five years. The pain was accompanied by occasional neck pain and was exacerbated by cold. The patient, who had not sought medical advice previously, considered elective disarticulation of his left finger's distal interphalangeal joint for pain relief.
Upon examination, the patient exhibited sharp tenderness, swelling, and a positive Love's pin test, Hildreth's test, and cold test. X-ray imaging revealed depressions on the dorsal aspect of the distal phalanx, while magnetic resonance imaging (MRI) confirmed a glomus tumor measuring 0.3 cm × 0.3 cm × 0.5 cm in size.
Glomus tumors are rare benign hamartomas primarily found in the dermis or subcutaneous tissue, with a high concentration in the subungual area of the fingers. These tumors often present as a faint bluish-purple papule with cold hypersensitivity, paroxysmal pain, and point tenderness. Although glomus tumors can rarely be found in other locations such as the lungs, pancreas, stomach, genitourinary tract, and gastrointestinal tract, the case presented here is typical of the subungual variety.
Diagnosis of glomus tumors relies on clinical suspicion supported by histopathology confirming the presence of glomus cells around vascular channels, and immunohistochemistry positive for markers such as CD34, vimentin, and α-smooth muscle actin. In this case, histopathology showed perivascular proliferation of homogenous round cells with round-to-ovoid nuclei arranged in multicellular layers around blood vessels, confirming the diagnosis.
The tumor was surgically excised, leaving the patient asymptomatic. Initial laboratory investigations revealed a normal leukocyte count, hemoglobin, platelet count, creatinine, and negative rheumatoid factor, but an elevated uric acid. The patient reported pain relief and complete symptom resolution after tumor removal, with no recurrence during a 2-year follow-up.
In Africa, no comprehensive epidemiological studies specifically quantifying the prevalence of glomus tumors exist in the literature accessible, nor do reports suggest different typical presentations from those described elsewhere. However, the lack of focused epidemiological and genetic research limits definitive comparative conclusions. The main challenges in Africa may be related to healthcare access rather than tumor biology itself.
In conclusion, glomus tumors in Africa appear to have similar clinical presentation and standard diagnostic and treatment approaches as in other regions. However, the limited data available makes it difficult to draw definitive conclusions about the prevalence and typical presentation of glomus tumors in Africa compared to other regions. The main challenges in Africa may be related to healthcare access rather than tumor biology itself.
- Despite the patient's initial consideration of elective disarticulation, the suspected medical-condition was confirmed to be a glomus tumor through magnetic resonance imaging (MRI), a technology rooted in science.
- The case presented highlights the importance of science in the diagnosis and treatment of chronic diseases like glomus tumors, which can affect various parts of the body, including skin-care and neurological-disorders.
- In Africa, while no comprehensive epidemiological studies on the prevalence of glomus tumors exist, it is suggested that the main challenges in diagnosing and treating these conditions might not be related to the tumor biology, but rather healthcare access.
- Health-and-wellness, a universal concern, involves not only the prevention and treatment of cancer and other severe diseases, but also the management of lesser-known conditions like skin-conditions and neurological-disorders, as demonstrated in this case of a glomus tumor.
