手指血管球瘤26例临床分析

目的　探讨手指血管球瘤的诊断和手术方法。方法　 1996年 1月 -2 0 0 2年 12月 ,对 2 6例手指血管球瘤进行诊治。术前 2 6例Love氏试验阳性 ,冷敏感试验阳性 ,2 0例Hildreth氏试验阳性 ,15例中 11例透光试验阳性 ,1例X线侧位片显示末节指骨有肿瘤压迹。全部病例均采取肿瘤切除手术。结果　术后随访 11个月～ 7年 9个月 ,无 1例肿瘤复发。 2 6例疼痛完全消失 ,术前阳性症状全部消失。 2 2例指甲生长良好 ,无明显畸形。结论　提高对血管球瘤的认识 ,有助于早期诊断 ,早期治疗 ,完整切除肿瘤是提高临床疗效的关键。

Clinical analysis of 26 cases of glomus tumors of the hand

ObjectiveA series of surgically treated glomus tumors of the fingers were reviewed to discuss the diagnostic characteristics and treatment outcomes of this clinical entity.Methods26 cases of glomus tumors of the fingers treated from January 1996 to December 2002 were reviewed. Surgical excision was done in all cases. Love's test, Hildreth's test, cold intolerance test, and the existence and severity of pain were recorded and compared pre and post operatively. Follow up ranged from 11 months to 7 years and 9 months. Twenty two subungual glomus tumours were excised by dorsal transungual approach without nail removal.ResultsThere were 20 women and 6 men with an average age of 36 years. All tumors were located in the distal phalanx. All digits were involved, with a distribution as follows: 4 thumbs, 9 index fingers, 4 long fingers, 8 ring fingers and 1 little finger. Twenty two tumors were subungual and 4 subcutaneous. Spontaneous pain occurred in 24 patients that lasted for a few minutes and disappeared spontaneously. All 26 patients had positive Love's test and cold intolerance test. 20 of them had positive Hildreth's test. Indentation of the distal phalanx was seen on X ray of 1 patient. After tumor excision, all 26 patients had total pain relief. Positive signs disappeared. None had a cosmetically unacceptable nail deformity in 22 patients with subungual glomus tumors. No patient of this series experienced recurrence of the tumor and symptoms.ConclusionA better understanding of the clinical manifestation of glomus tumor shall lead to early diagnosis. Once identified, complete excision of the tumor is the treatment of choice.