Dermatologic Manifestations of Glomus Tumor Treatment & Management

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

Surgical Care

The treatment of choice for symptomatic solitary glomus tumors is total surgical excision, [30]  which is curative. While various treatment modalities have been reported, to include laser and sclerotherapy, in the case of solitary glomus tumors, complete removal of the tumor capsule is recommended to relieve pain and minimize risk for recurrence.

Most subungual lesions are treated with total nail avulsion followed by excision, although several additional techniques have been described to include a straightforward excision using a nail bed margin approach, [31] a trap-door technique, [32] as well as a technique described by Lee et al designed to conserve the nail plate itself. [33]

Glomus tumors that are skin-colored or located in the nail matrix have a higher incidence of recurrence. However, the use of preoperative magnetic resonance imaging or ultrasound studies is associated with a lower incidence of recurrence and may be helpful in these cases. [34]

For multiple glomus tumors, excision may be more difficult because of their poor circumscription and the large number of lesions. Other reported treatment modalities, more useful in treating multiple lesions, include argon, carbon dioxide or ND:YAG laser therapy, as well as sclerotherapy with hypertonic saline or sodium tetradecyl sulfate. [35, 36, 37]

The treatment recommendations for glomangiosarcoma are based on a few case reports. Wide local excision is adequate treatment and probably is the treatment of choice.