Post-traumatic glomus tumor of the left anterior supraclavicular nerve: a case report

ABSTRACT

Objectives

Peripheral nerve glomus tumors are extremely rare and occur with typical symptoms of peripheral neuropathic pain. Clinicians hardly consider this entity when faced with the swelling of a peripheral nerve and the diagnosis is reached only with histological examination. Nerves of limbs are usually affected and the solid glomus tumor is the most frequent histological variant.

Case Description

A 55-year-old man presented with a glomus tumor of the anterior supraclavicular nerve of the left cervical plexus, misdiagnosed clinically and radiologically as neuroma. Despite the preoperative suspicion and the intraoperative appearance, the histological examination revealed a glomus tumor with a prevalent muscular component, a glomangiomyoma. Once the tumor was removed, pain regressed completely.

Conclusions

Because of its rarity, pre-operative diagnosis of glomus tumors is still a challenge, especially when arising from peripheral nerves. In the presence of chronic localized neuroma-type pain and sensitivity, glomus tumors should be considered in the pool of differential diagnosis, even if the imaging is not conclusive.

KEYWORDS:

• Glomus tumor
• traumatic neuroma
• glomangioma
• glomangiomyoma
• peripheral nerve tumor

Acknowledgments

We thank Dr Camilla Mencarani, Department of Peripheral Nerve Surgery, Ospedale Civile degli Infermi, for the provision of the patient.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author contributions

Alessandra Turrini: Data curation, writing – original draft preparation. Guido Staffa: Clinical and surgical activity, supervision. Giulio Rossi: Provision of histological photos and curation of their descriptions. Crescenzo Capone: Conceptualization, visualization, supervision.

Data availability statement

The authors declare that data supporting the findings of this study are available within the article.

Additional information

Funding

The authors reported there is no funding associated with the work featured in this article.

Notes on contributors

Alessandra Turrini

Alessandra Turrini is last year resident at the Department of Neurosurgery of University of Padua, Italy. She spent the last year of her traineeship in the Department of Peripheral Nerve Surgery of the “Ospedale degli Infermi” di Faenza, Ravenna, Italy, to expand her knowledge in peripheral nerve surgery and improve her research activities. Guido Staffa is a Neurosurgeon and previous Chief of the Department of Neurosurgery and Peripheral Nerve Surgery at the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main surgical and clinical activity concerns all fields of peripheral nerve surgery, traumatic and degenerative spine surgery and vascular neurosurgery. Giulio Rossi is Head of the Department of Pathology of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. He teaches Pulmonary Pathology at the University of Modena and Reggio Emilia Italy. He is author of more than 300 scientific publications, and member of the Editorial Board of many anatomical pathology journals. Crescenzo Capone is a Neurosurgeon at the Department of Neurosurgery and Peripheral Nerve Surgery of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main research focus are peripheral nerve tumors, traumatic/compression peripheral nerves lesions and Hand Function Restoration in Tetraplegic Patients.

Guido Staffa

Alessandra Turrini is last year resident at the Department of Neurosurgery of University of Padua, Italy. She spent the last year of her traineeship in the Department of Peripheral Nerve Surgery of the “Ospedale degli Infermi” di Faenza, Ravenna, Italy, to expand her knowledge in peripheral nerve surgery and improve her research activities. Guido Staffa is a Neurosurgeon and previous Chief of the Department of Neurosurgery and Peripheral Nerve Surgery at the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main surgical and clinical activity concerns all fields of peripheral nerve surgery, traumatic and degenerative spine surgery and vascular neurosurgery. Giulio Rossi is Head of the Department of Pathology of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. He teaches Pulmonary Pathology at the University of Modena and Reggio Emilia Italy. He is author of more than 300 scientific publications, and member of the Editorial Board of many anatomical pathology journals. Crescenzo Capone is a Neurosurgeon at the Department of Neurosurgery and Peripheral Nerve Surgery of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main research focus are peripheral nerve tumors, traumatic/compression peripheral nerves lesions and Hand Function Restoration in Tetraplegic Patients.

Giulio Rossi

Alessandra Turrini is last year resident at the Department of Neurosurgery of University of Padua, Italy. She spent the last year of her traineeship in the Department of Peripheral Nerve Surgery of the “Ospedale degli Infermi” di Faenza, Ravenna, Italy, to expand her knowledge in peripheral nerve surgery and improve her research activities. Guido Staffa is a Neurosurgeon and previous Chief of the Department of Neurosurgery and Peripheral Nerve Surgery at the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main surgical and clinical activity concerns all fields of peripheral nerve surgery, traumatic and degenerative spine surgery and vascular neurosurgery. Giulio Rossi is Head of the Department of Pathology of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. He teaches Pulmonary Pathology at the University of Modena and Reggio Emilia Italy. He is author of more than 300 scientific publications, and member of the Editorial Board of many anatomical pathology journals. Crescenzo Capone is a Neurosurgeon at the Department of Neurosurgery and Peripheral Nerve Surgery of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main research focus are peripheral nerve tumors, traumatic/compression peripheral nerves lesions and Hand Function Restoration in Tetraplegic Patients.

Crescenzo Capone

Alessandra Turrini is last year resident at the Department of Neurosurgery of University of Padua, Italy. She spent the last year of her traineeship in the Department of Peripheral Nerve Surgery of the “Ospedale degli Infermi” di Faenza, Ravenna, Italy, to expand her knowledge in peripheral nerve surgery and improve her research activities. Guido Staffa is a Neurosurgeon and previous Chief of the Department of Neurosurgery and Peripheral Nerve Surgery at the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main surgical and clinical activity concerns all fields of peripheral nerve surgery, traumatic and degenerative spine surgery and vascular neurosurgery. Giulio Rossi is Head of the Department of Pathology of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. He teaches Pulmonary Pathology at the University of Modena and Reggio Emilia Italy. He is author of more than 300 scientific publications, and member of the Editorial Board of many anatomical pathology journals. Crescenzo Capone is a Neurosurgeon at the Department of Neurosurgery and Peripheral Nerve Surgery of the “Ospedale degli Infermi” of Faenza, Ravenna, Italy. His main research focus are peripheral nerve tumors, traumatic/compression peripheral nerves lesions and Hand Function Restoration in Tetraplegic Patients.