Glomus tumor

Capillary hemangioma is a very common disease in daily life. It is a vascular malformation that often occurs in the inner layer of the extremities. It can easily cause great harm to human health, so it is particularly important to have a certain understanding of this disease. Capillary hemangiomas are generally divided into single-type and multiple-type. Patients can find the cause through examination and then choose the appropriate treatment method according to their physical condition to recover their health as soon as possible.

Glomus tumor

Strictly speaking, glomus tumor is a vascular malformation. It usually occurs in the neuromuscular glomus in the reticular layer of the inner layer of the extremities. It is a transformation of the arteriovenous shunt (arteriovenous anastomosis) before the capillary network, that is, the glomus is transformed. It is an anastomotic device that directly introduces the small arteries distributed in the extremities into the vein without passing through the capillary network, and controls the blood flow with its neuromuscular contraction, thereby regulating local temperature and skin circulation.

2. The composition of the glomerulus is composed of 5 parts

① Afferent arteriole; ② Anastomotic tube (also called Sucquet-Hoyer tube); ③ Primitive collecting vein; ④ Reticular structure within the bulb; ⑤ Capsule. In 1920, Barr'e removed a painful subungual tumor, and Masson performed a pathological dissection on the tumor and named it glomus tumor. Pathological observation: There are many blood vessels in the tumor with thick walls. The Sucquet-Hoyer ducts are tortuous and dilated, and their arrangement is similar to that of hemangioma. The outer layer of these blood vessels is surrounded by neat, regular, and uniformly sized epithelial cells. The inner layer of the blood vessels is a single layer of inner cells supported by a fibrous layer. Collagen fibers exist between the inner cells and serve as the matrix of the tumor. Masson divided his microscopic findings into four types: ① Vascular type, which is mainly composed of blood vessels. ② A small number of blood vessels and a large amount of myoendothelial matrix type. ③Nerve fiber type. ④ Degenerative type: hyaline degeneration and myxoid degeneration caused by edema.

Glomus tumors are often found under the fingernails or toenails and have certain characteristics in clinical manifestations. Although the disease is rare, it is often misdiagnosed or missed.

3. Types of symptoms

Clinically, glomus tumors are divided into two types: ① Single-type, which is more common and has three typical clinical symptoms: spontaneous pain, tenderness and cold sensitivity. ②Multiple hair types: may occur in multiple parts of the body or multiple parts of the body may occur in one part. Rarely, patients with multiple tumors may have "constant-diameter artery syndrome, diffuse arteriovenous fistula, or visceral arteriovenous fistula."

The typical symptom of patients with subungual hemangioma is localized pain that leads to medical treatment. The pain occurs in paroxysmal or continuous patterns, with obvious local tenderness. The pain can be stimulated or aggravated by cold, and the nature of the pain is stabbing or burning, and is severe. There are several explanations for why glomus tumors cause pain. Some people believe that there are mast cells in hemangioma, and the pain-causing substances released by mast cells, such as 5-hydroxytryptamine and histamine, stimulate the surrounding pain receptors and cause severe pain. Some people also believe that the pain is caused by nerve fibers that wrap around blood vessels and pass through the tumor, and that the number of nerve endings is related to the degree of pain. Others believe that pain is related to changes in blood flow through the glomus tumor, and that changes in blood flow stimulate nerve fibers to produce pain.

Physical examination shows that the subungual tumor is purple or purple-red, and may have localized protrusions. The tumor is 2 to 5 mm in size, light pink or red, with a complete capsule, soft texture, clear boundaries, and no adhesions. The tumor contains many blood vessels, and around the blood vessels are multiple layers of epithelial-like cells that are uniform in size and neatly arranged. The tumor is wrapped by fibrous tissue. There is also evidence that glomus tumor organizers cannot be seen.

4. Physical Examination

A positive Loves test means that pressing the surface of the tumor with a paper clip or a pin cap may produce severe pain that radiates to the forearm or upper arm, but there is no pain when pressing slightly away from the tumor.