Diagnostic Delay and Clinical Characteristics of Glomus Tumors in the Hand: A Case Series of 11 Patients

Background: The aim of this study is to analyze the clinical characteristics of glomus tumors of the hand, with particular focus on diagnostic delay, tumor location, and the roles of physical examination and magnetic resonance imaging (MRI) in preoperative diagnosis. Methods: This retrospective case series included 11 patients with histopathologically confirmed glomus tumors of the hand treated at a single institution between 2014 and 2021. Clinical characteristics and physical examination findings were evaluated in all patients. MRI findings and their concordance with pathological diagnosis were analyzed in the subset of patients who underwent preoperative MRI (n = 9). Analyses were primarily descriptive. Results: The cohort consisted of eight women (73%) and three men (27%), with a mean age of 39.6 ± 10.3 years. Tumors were located in the subungual region in eight patients (73%) and in non-subungual regions in three patients (27%). The mean duration from symptom onset to diagnosis was 8.6 ± 6.3 years, with comparable durations between subungual and non-subungual tumors. Localized point tenderness was observed in 10 patients (91%), whereas cold hypersensitivity was present in four patients (36%), and the complete symptom triad was observed in four patients (36%). Preoperative MRI was performed in nine patients and demonstrated a high lesion detection rate; however, accurate preoperative diagnosis was achieved in only six of nine patients (67%). None of the non-subungual tumors were correctly diagnosed before surgery. No single MRI sequence consistently provided optimal lesion visualization across cases. All patients underwent complete surgical excision, resulting in complete symptom resolution without recurrence. Conclusions: Glomus tumors of the hand are associated with prolonged diagnostic delay regardless of tumor location. Although MRI is useful for detecting lesions, it is insufficient for establishing a definitive preoperative diagnosis. In contrast, localized point tenderness is a consistent and clinically valuable finding that may play a key role in raising diagnostic suspicion. These findings highlight the importance of integrating clinical symptoms, physical examination, and imaging to achieve accurate and timely diagnosis.