Intraoperative transillumination as an adjunctive localization technique for subungual glomus tumors

This study aimed to evaluate the positivity rate of transillumination among histopathologically confirmed subungual glomus tumors. We hypothesized that transillumination would demonstrate a high positivity rate comparable to those of commonly used diagnostic methods. The primary outcome was the positivity rate of the evaluated diagnostic methods, including the Love test, Hildreth test, preoperative transillumination, intraoperative transillumination, and preoperative magnetic resonance imaging (MRI). A retrospective study was conducted on 32 patients diagnosed with subungual GTs who underwent transungual surgical excision between January 2024 and January 2026. All patients were over 18 years old, had at least six months of follow-up, and underwent preoperative clinical tests, preoperative MRI, and transillumination assessment. Intraoperative transillumination was also performed. Positivity rates were compared using the exact McNemar test for paired binary data, with Bonferroni correction for multiple pairwise comparisons. Positivity rates were reported with 95% confidence intervals. The mean age was 37.6 ± 9.1 years, and 68.8% were women. The Love test was positive in all patients (100%), followed by MRI (96.9%), intraoperative transillumination (87.5%), Hildreth test (78.1%), and preoperative transillumination (78.1%). No significant differences were observed between diagnostic methods after Bonferroni correction. The complication and recurrence rates were 6.2% and 9.4%, respectively. No significant associations were found between demographic variables and clinical outcomes. Owing to the case-only design and absence of a disease-negative comparison group, diagnostic accuracy measures could not be determined. Transillumination demonstrated relatively high positivity rates among histopathologically confirmed subungual glomus tumors and may represent a promising, simple, and low-cost adjunctive localization tool. However, it should not be considered a validated alternative to established clinical and imaging modalities, and its diagnostic and intraoperative utility requires prospective validation