Case of the Month
A 13 year old girl was seen for acne treatment and this agminated patch of blue papules, with a faint central linear scar, was noticed on her forearm during the encounter. She reported that the area was present ever since she could remember, probably near or since birth. The area was surgically removed about 5 years prior. She notes that the bumps have started to return over the last few years. She reported that the area was mildly sensitive to pressure, but not excruciating. A definite nuisance when wearing tight sleeved shirts, sweaters or coats. She mentioned that she also had an upcoming appointment with the surgeon for re-evaluation and possible re-excision.What's Your Diagnosis?
There is a group of vascular tumors who are both benign and have the presence of glomus cells. They can be divided into two main categories:
- Glomuvenous Malformations (also called Glomangioma)
- Glomus Tumors
Glomus tumors usually present as a singular nodule that is often very tender/painful. Glomus tumors commonly occur on the extremities, especially in subungual locations.
Glomuvenous malformations (a.k.a. glomangiomas) usually present in early childhood as a group of blue, relatively painless, nodules. They can be located anywhere on the body.
There are other , more rare variants, one associated with muscle cells, called an glomangiomyoma and even more rare, malignant variant.
Some reports indicate a higher incidence of neurofibromatosis with the condition. Although distinct, glomangiomas can be confused with Blue Rubber Bleb Nevus syndrome.
Treatment is based on the presence of symptoms and/or location. Surgical excision is the preferred treatment modality.
For a nice review article please see:
Glomangioma: A Case Report and Review of the Literature Cutis. Schopp and Wilkerson. 2009 January;83(1):24-27
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