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Dermatologic Manifestations of Glomus Tumor

  • Author: Jon H Meyerle, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: May 26, 2016


Glomus tumors are rare soft tissue neoplasms that typically present in adults (ages 20-40 years) as small, blue-red papules or nodules of the distal extremities, with most cases involving subungual sites. These tumors are typically painful, often causing paroxysmal pain in response to temperature changes or pressure.

Note the images below.

Glomus tumor. Glomus tumor.
Multiple glomus tumors. Multiple glomus tumors.

Glomus tumors are thought to arise from the glomus body, a thermoregulatory shunt concentrated in the fingers and toes. Most lesions are solitary and localized to cutaneous sites; however, generalized glomuvenous malformations, or multiple glomangiomas, have also been described, and may have extracutaneous involvement.

While the vast majority of glomus tumors are benign, malignant cases have been rarely reported, with such cases typically being locally invasive, and with metastases being exceedingly rare.[1, 2, 3, 4]



Glomus tumors are thought to represent hamartomatous proliferations of modified smooth muscle cells originating from preexisting normal glomus cell populations. Glomus cell populations are specialized arteriovenous anastomoses found most often in the fingers and are characterized by Sucquet-Hoyer canals, which play an important role in thermoregulation.

Interestingly, while glomus tumors predominate on the hands and fingers especially, these tumors can occur in a wide anatomic distribution, to include sites not known to contain glomus cells. One explanation for this finding is that these tumors may arise from perivascular cells that can differentiate into glomus cells.

Most glomus tumors are solitary and sporadic, but some cases of glomus tumor are multiple. These disseminated variants of glomus tumor, known as glomangiomas or glomuvenous malformations, differ clinically from glomus tumors in that they occur more often in children and adolescents, are typically multifocal, and do not have a predilection for subungual sites.

It is thought that glomangiomas and glomus tumors have different etiologies, with glomangiomas resembling venous malformations and containing more dilated venous channels than glomus tumors.

Note that most cases of glomangiomas manifest as sporadic tumors; however, familial cases with autosomal dominant inheritance patterns have also been described. Such familial glomangiomas have been mapped to 1p21-22 and are thought to result from loss-of-function mutations in the cytoplasmic protein glomulin.[5, 6, 7, 8]




Glomus tumors account for 1-5% of all soft tissue tumors of the upper extremity, occurring in most cases in the nail bed[9] ; however, the true incidence of glomus tumors is unknown, likely as a result of misdiagnosis of many of these lesions as hemangiomas or venous malformations.

The multiple variant of glomus tumor — generalized glomuvenous malformations, or multiple glomangiomas — is much less common, accounting for less than 10% of all reported cases.[7] Such cases are seen more frequently in children, with the majority of patients reporting a positive family history.


Glomus tumors in general show no sex predilection; however, solitary subungual lesions are more commonly observed in women and multiple lesions are slightly more common in men.


Solitary glomus tumors can occur at any age, but they are most frequent in young adults. Glomangiomas, or glomuvenous malformations, are often multifocal and typically present in children; indeed, many are congenitally present.



The prognosis for patients with glomus tumors is excellent. Excision of painful lesions most often results in cure, with a low recurrence rate for solitary lesions.[10, 11]   Malignant glomus tumors are extremely rare and usually are locally aggressive. Their overall prognosis is good if they are treated with wide excision. However, metastases do occur and are associated with a very poor prognosis.

Patients with glomus tumors classically present with paroxysmal severe pain, often precipitated by cold, pressure, or dependency. Pain is more frequent in solitary lesions; multiple tumors—classically seen as glomuvenous malformations—arise in younger patients and tend to be asymptomatic.

In one report, a patient with more than 400 glomus tumors had thrombocytopenia as a result of platelet sequestration (ie, Kasabach-Merritt syndrome).

Extremely rare instances of malignant transformation within glomus tumors have been described; these typically represent a locally infiltrative malignancy; however, metastases have been described.[1, 2, 12, 13]


Contributor Information and Disclosures

Jon H Meyerle, MD Assistant Professor, Department Dermatology, Uniformed Services University of the Health Sciences; Assistant Professor, Department of Dermatology, Johns Hopkins University School of Medicine; Chief, Immunodermatology, Walter Reed National Military Medical Center

Jon H Meyerle, MD is a member of the following medical societies: American Academy of Dermatology, Sigma Xi

Disclosure: Nothing to disclose.


Erin L Spillane, MD Staff Dermatologist, Department of Dermatology, Womack Army Medical Center

Erin L Spillane, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Christen M Mowad, MD Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Abby S Van Voorhees, MD Assistant Professor, Director of Psoriasis Services and Phototherapy Units, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania

Abby S Van Voorhees, MD is a member of the following medical societies: American Academy of Dermatology, Women's Dermatologic Society, National Psoriasis Foundation, American Medical Association, Phi Beta Kappa, Sigma Xi

Disclosure: Received honoraria from Amgen for consulting; Received honoraria from Abbott for consulting; Partner received salary from Merck for management position; Received honoraria from Abbott for speaking and teaching; Received honoraria from Amgen for review panel membership; Received honoraria from Centocor for consulting; Received honoraria from Leo for consulting; Received none from Merck for other.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Omar P. Sangueza, MD, and Michael B. Reynolds, MD, to the original writing and development of this article.

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Glomus tumor.
Multiple glomus tumors.
Glomus tumor (4X). The tumor is composed of uniformly round, small, glomus cells with pale eosinophilic cytoplasm associated with conspicuous vasculature.
Glomus tumor (10X).
Glomangioma (2X). In this variant, blood vessels predominate.
Glomangioma (10X). Note the typical small, round glomus cells, often distributed in a monolayer or bilayer within the vessel walls.
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