Glomus tumor of the right little finger: a case report and review of diagnostic challenges

Introduction and importance: Glomus tumors are rare, benign growths originating from the glomus body, typically presenting with severe pain, pinpoint tenderness, and sensitivity to cold. Their small size and rarity often lead to misdiagnosis, with an average delay of 7 years. Case presentation: This report details a 37-year-old man experiencing burning pain in his right little finger, aggravated by cold, for 6 months. Magnetic resonance imaging (MRI) showed a lesion indicative of a glomus tumor, confirmed by histopathology after surgical excision. Clinical discussion: Differential diagnoses include other painful lesions such as leiomyoma, eccrine spiradenoma, neuroma, hemangioma, retained foreign bodies, and gouty arthritis, as well as hyperpigmented lesions like melanoma, nevi, pyogenic granuloma, and angioma. Clinical tests such as the Love, Hildreth, Cold, and Joseph-Posner tests assist in clinical diagnosis, while MRI and ultrasound imaging provide additional support. Surgical excision is the definitive treatment, though recurrence may occur. To reduce recurrence, surgery is performed with loupe magnification and double tourniquet exsanguination. Histopathology remains the diagnostic gold standard.