Asian Journal of Case Reports in Surgery

Background: Glomangioma is an uncommon variant of glomus tumour that may present with persistent subungual pain and can be difficult to diagnose because of its small size and non-specific clinical appearance.

Aims: To present a rare case of subungual glomangioma; highlight the diagnostic challenges, the roles of imaging and histopathology, and the importance of surgery as definitive treatment; and increase awareness of this uncommon variant of glomus tumour presenting as chronic subungual pain.

Presentation of Case: A 47-year-old female patient presented with chronic pain over the nail bed of the right thumb for 2 years. The patient reported sharp pain whenever pressure was applied to the volar tip. On examination, a small swelling with point tenderness was noted. The Love’s pin test confirmed the point tenderness.

Discussion: Glomus tumours are uncommon benign vascular tumours arising from the glomus body. They account for approximately 1–5% of soft tissue tumours of the hand. They are usually solitary and range in colour from deep blue to purple. The average age at presentation ranges from 30 to 50 years. Patients typically present with the classic triad of severe pain, point tenderness, and cold sensitivity. The cause of this tumour is unknown. Due to their small size and non-specific presentation, diagnosis is often delayed. Rarely, these tumours can become malignant.

Conclusion: Glomus tumours are often small, located deep in the fingertips, and difficult to palpate, making timely diagnosis difficult. They should be suspected in patients with chronic fingertip pain and point tenderness. Early diagnosis and complete surgical excision using a transungual approach provide excellent outcomes.