Cutaneous pain without tumor: a manifestation of occult synovioma

A thirty-four year old male presented with severe spot tenderness for eighteen months, situated in the right upper anterior thigh. The skin was normal. No tumor, swelling, or inflammation was found. On the basis of a clinical diagnosis of glomus tumor, the area was biopsied and a microscopic synovioma was documented in the fascia just deep to the subcutis. From the literature, it is apparent that approximately 20 percent of the patients with this cancer go through a pretumor phase characterized by only sustained pain or tenderness. By detecting the lesion in this phase, the dermatologist can contribute substantially to an increased cure rate, which has lingered at about 50 percent for at least ten years.