Glomus tumor surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]

Overview

Surgery is the mainstay of treatment for glomus tumor.

Surgery

• Surgery is the mainstay of treatment for glomus tumor.
• Surgical resection may be performed via two approaches:
  • Transungual
    • The nail plate is removed and an incision is made on the nail bed.
    • The nail bed is elevated to expose the tumor adequately for removal.
    • It is then followed by extensive repair of the nail bed.
    • The transungual approach is the simplest and gives the best exposure of the nail bed.
  • Lateral subperiosteal
    • An incision is made dorsal to the mid-lateral line.
    • Dissection is performed to the distal phalanx and a dorsal flap consisting of skin, nail plate, nail bed and germinal matrix tissue is elevated in a single layer.
  • Laterodigital Keyser-Littler approach
    • This is a high mid-lateral approach from below the paronychial fold.
    • The distal phalangeal ligament (which provides lateral support to the nail matrix and nail plate) is identified and retracted.
    • The nail matrix is elevated over the ligament and the dorsal cortex of the distal phalanx, followed by resection of the tumor.

• 

  Surgical extraction of a glomus tumor from a fingertip. The tumor is the translucent oblate spheroid in the center of the incision, approximate horizontal dimension is 4 millimeters.