Imaging features of glomus tumors

Objective To describe the imaging findings with pathologic correlation and clinical presentation of glomus tumors. Materials and methods We retrospectively searched the surgical pathology database from January 1, 1997, to April 30, 2010, for cases of pathologically proven glomus tumor. Patients who had imaging results available for review were included in the study. Results Glomus tumors presented with a prolonged history of focal and often debilitating pain, with a mean duration of symptoms of 7.2 years. Mean tumor size was 13 mm. The upper extremity was involved in 12/25 (48%) of the tumors, the lower extremity in 12/25 (48%), and one case (4%) was within the trachea. Lesions appeared well circumscribed on ultrasonography, with marked vascularity on color Doppler evaluation. Magnetic resonance imaging (MRI) with a marker placed in the region of point tenderness was the best method for identifying small glomus tumors. These tumors had a high T2 signal and uniform enhancement after gadolinium administration. Conclusions The diagnosis of glomus tumor is suggested by imaging features of a small circumscribed mass at the site of point tenderness that show marked vascularity on Doppler evaluation or diffuse contrast medium enhancement on MRI, or both. Early tumor recognition allows surgical resection that completely resolves the crippling, chronic pain of these lesions.