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Glomus tumour of the fingertip

A 15-year-old girl presented with sharp stinging sensation on her left middle finger for nearly a year. She pointed to a bluish discoloration at the base of the nail plate as the cause of her problem (Fig. 1). The offending lesion was removed via a transungual approach. The pain never recurred after excision. A middle-aged woman also presented with similar complaints on the side of her right ring finger. She had been to multiple physicians before one of them decided to take a magnetic resonance imaging (MRI; Fig. 2) of her hand, which revealed the diagnosis. She was referred to the plastic surgical outpatient department and was posted for excision biopsy. On table, a pale red, well-defined mass was visualized, on one side of the distal phalanx (Fig. 3). The mass was excised and the biopsy confirmed the preoperative diagnosis. Glomus tumour is a small pea-shaped tumour, commonly described in young females. They are often found near the fingertips. Lancinating pain even on slight touch is characteristic. The pain can be more in cold climate. Preoperative tests, which are employed to diagnose the tumour, are Love’s pin test and Hildreth’s test. In Love’s test, the examiner uses a pinhead to specifically localize the area of maximum pain on the finger. In Hildreth’s test, the affected limb is exsanguinated and an arm tourniquet is inflated. On deflation of the tourniquet, the patient has exacerbation of local pain. These tumours are abnormal enlargements of the normal glomus bodies. They are composed of an arteriole, a connection called the Sucquet-Hoyer canal and a draining venule. Glomus cells are contractile and surround the canal. They regulate local blood flow and temperature. The density of these cells is more in fingertips,