Multifocal Glomus Tumors in Different Fingers with Metachronous Clinical Presentation: A Case Report

Glomus tumors are benign neoplasms arising from the glomus body. They commonly occur in the distal fingers and subungual region and typically present with severe localized paroxysmal pain, point tenderness, and cold sensitivity. Although the lesions are small, they can cause long-standing and marked pain. An adult woman presented in 2018 with localized pain in the pulp of the left ring finger. Ultrasonography and contrast-enhanced MRI identified a small lesion, which was surgically excised and histopathologically confirmed as a glomus tumor. Importantly, the same magnetic resonance imaging (MRI) examination also demonstrated a separate enhancing lesion in the distal left index finger, although this lesion was clinically asymptomatic at that time. Approximately seven years later, the patient developed localized pain in the distal index finger. Repeat MRI demonstrated a lesion in the same anatomical region, and surgical excision followed by histopathological examination again confirmed a glomus tumor. These findings support synchronous glomus tumors in different fingers, with delayed symptomatic presentation of the index-finger lesion. In patients with well-localized and recurrent digital pain, even when there is a history of glomus tumor, diagnosis and management should follow the principle of relocalizing a new lesion. Combined assessment with ultrasonography and contrast-enhanced MRI may improve the localization accuracy of small lesions and guide surgical strategy.