A case of a glomus tumor presenting as an atypical hyperkeratotic papule of the hypothenar palm

Fig 1. A glomus tumor of the hypothenar eminence. Photo from clinical examination shows a hyperkeratotic papule. Note the resemblance of a foreign body. INTRODUCTION Glomus tumors are rare, benign vascular neoplasms typically localized to the digits, with a propensity for the subungual region of the hand. These subcutaneous hamartomas are derived from hyperplasic modified smooth muscle cells, specifically from the thermoregulatory glomus body found at the reticular dermis. Clinical characteristics include a triad of severe focal paroxysmal pain, pinpoint tenderness, and cold sensitivity, often presenting as a raised red or blue-colored, painful nodule at acral or subungual areas. However, glomus tumors are also reported in extradigital locations, especially in men. The low incidence and varying presentations of glomus tumors pose a diagnostic challenge, leading to delayed diagnosis and unnecessary pain. Here we describe a patient with an atypical clinical presentation of a glomus tumor, uniquely located at the hypothenar eminence of the hand and resembling a foreign body granuloma.