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Recurrent Glomus Tumors of Fingertips: MR Imaging Evaluation¹

¹ From the Department of Radiology B, CHU Cochin, AP-HP-Université Paris V, 27 rue du fg Saint-Jacques, 75014 Paris, France (N.H.T., A.C., J.L.D.); Department of Radiology, CHUV, Lausanne, Switzerland (N.H.T.); Department of Radiology, Veterans Administration Medical Center, San Diego, Calif (N.H.T., D.R., C.B.C.); Department of Dermatology, CHU Bichat, Université Paris IX, France (S.G.); Institut de la Main, Clinique Jouvenet, Paris, France (D.L.V.); and Centre Inter Etablissement de Résonance Magnétique (CIERM), Hôpital de Bicêtre, AP-HP-Université Paris XI, Le Kremlin-Bicêtre, France (J.B., J.L.D.). From the 1997 RSNA scientific assembly. Received May 29, 2001; revision requested June 26; revision received September 27; accepted October 16. Supported by the Swiss Radiological Society. Address correspondence to J.L.D. (e-mail: jean-luc.drape@cch.ap-hop-paris.fr).

PURPOSE: To determine the magnetic resonance (MR) imaging findings in recurrent glomus tumors of the fingertips.

MATERIALS AND METHODS: Twenty-four consecutive patients with recurrent pain after previous excision of a glomus tumor of the fingertip underwent MR imaging studies and surgery. T1-weighted spin-echo MR images were obtained in each patient before and after intravenous injection of contrast material; T2-weighted spin-echo and three-dimensional gradient-recalled echo images were also obtained. MR angiography was performed in four patients. Postsurgical histopathologic analysis revealed recurrent glomus tumors in 22 patients. Signal intensity, enhancement, and margins of the scar tissue and the recurrent tumors at MR were assessed.

RESULTS: The postsurgical scars were depicted in 21 (88%) of 24 patients with all sequences but were best demonstrated on gradient-recalled echo MR images. Seven patients had undergone multiple surgical procedures and had extensive scar tissue and, in one case, a neuroma. In all patients, MR imaging revealed a nodule compatible with the diagnosis of a recurrent glomus tumor. In 13 (54%) of 24 patients, the nodule had typical features of a glomus tumor. In eight (33%) of 24 patients, the tumors had low signal intensity or isointensity compared with the nail bed on T2-weighted images. In six (25%) of 24 patients, the tumors had faint enhancement after intravenous gadolinium chelate administration. The margins of the tumors were blurred by scar tissue in nine of 24 cases.

CONCLUSION: MR imaging can aid in the evaluation of recurrent glomus tumors.

© RSNA, 2002

Index terms: Fingers and toes, MR, 436.121411, 436.121412 • Fingers and toes, neoplasms, 436.369 • Paraganglioma, 436.369

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