Extradigital Glomus Tumor Of The Foot

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Extradigital Glomus Tumor Of The Foot

Authors, Editors, Case Information Author: Kyler Wilson, MD Affiliation: Inova Family Medicine Residency Co Author(s): Timothy Yu, M.D., FAAFP, CAQSM, DipABLM, RMSK Senior Editor: Michael Krill, MD, ATC Clinical Vignette: A 54-year-old male presented with chronic left anterior ankle pain that started 15 years ago without injury. His exam revealed tenderness to palpation over the extensor hallucis longus and tibialis anterior tendons just proximal to the ankle joint (most tender ~2cm proximal to the anterior distal tibiofibular joint). Strength was intact with normal sensation and range of motion. Type of Probe Used: ML6-15 linear array transducer Unlabeled Long Axis View of the Left EHL Tendon at the Ankle Unlabeled Long Axis View of the Left EHL Tendon at the Ankle Unlabeled Long Axis View of the Left EHL Tendon at the Ankle with Doppler Unlabeled Long Axis View of the Left EHL Tendon at the Ankle with Doppler Labeled Long Axis View of the Left EHL Tendon at the Ankle with Doppler Labeled Long Axis View of the Left EHL Tendon at the Ankle with Doppler. Ill-defined mass abutting the anterior tibial artery between the tibialis anterior and extensor hallucis longus tendons. 2.7 x 0.8 x 1.1 cm. Notable blood flow proximally and within mass. Unlabeled Short Axis View of the Left Anterior Ankle Unlabeled Short Axis View of the Left Anterior Ankle Labeled Short Axis View of the Left Anterior Ankle Labeled Short Axis View of the Left Anterior Ankle with a hypoechoic mass between the tibialis anterior and extensor hallucis longus tendons. #6 - Video View Video Short axis cine of hypoechoic mass between the tibialis anterior and extensor hallucis longus tendons with no pulsation. #7 - Video View Video Long axis cine of hypoechoic mass between the tibialis anterior and extensor hallucis longus tendons, with Doppler flow of anterior tibial artery noted. Interpretation Image Interpretation: LAX view, ill-defined mass abutting the anterior tibial artery between the tibialis anterior and extensor hallucis longus tendons. 2.7 x 0.8 x 1.1 cm. Notable blood flow proximally and within mass observed with Doppler. Teaching Pearl: Glomus tumors are classically found in the digits, especially the fingers, so extradigital foot lesions can be difficult to recognize. Symptomatically, they can present with pinpoint tenderness, paroxysmal pain, and cold sensitivity, although the full triad may not be present. Ultrasound with Doppler can strengthen the diagnosis by identifying a small hypoechoic, tender, hypervascular soft tissue mass. When these findings are present, the lesion should not be aspirated. MRI or surgical referral can be appropriate for confirmation and management. References: 1. Catalano O, Alfageme Roldan F, Solivetti FM, Scotto di Santolo M, Bouer M, Wortsman X. Color Doppler sonography of extradigital glomus tumors. J Ultrasound Med. 2017;36(1):231-238. doi:10.7863/ultra.16.03023 2. Serra del Carpio G, Pena Burgos EM, Pozo Kreilinger JJ, Bernabeu Taboada D, Peletero Pensado M, Tapia Vine M. Case series of extradigital glomus tumors: imaging findings, differential diagnosis and radiologic-pathologic correlation. Egypt J Radiol Nucl Med. 2024;55:10. doi:10.1186/s43055-023-01178-8 3. Trehan SK, Soukup DS, Mintz DN, Perino G, Ellis SJ. Glomus tumors in the foot: case series. Foot Ankle Spec. 2015;8(6):460-465. doi:10.1177/1938640015583514
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Authors, Editors, Case Information

Unlabeled Long Axis View of the Left EHL Tendon at the Ankle

Unlabeled Long Axis View of the Left EHL Tendon at the Ankle with Doppler

Labeled Long Axis View of the Left EHL Tendon at the Ankle with Doppler

Unlabeled Short Axis View of the Left Anterior Ankle

Labeled Short Axis View of the Left Anterior Ankle

#6 - Video

#7 - Video

Interpretation

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