Rare, very painful and hard-to-find tumour successfully treated in UAE hospital

A rare , very painful and hard-to-find tumour has been successfully treated by a doctor at a hospital in the UAE.

Thomas, a 50-year old senior executive in an international company, had been suffering from severe pain in his right thumb for the past few years.

He visited several doctors but to no avail.  He even unsuccessfully attempted to have steroid injected to relieve the pain.

Finally, on a business visit to RAK Hospital in Ras Al Khaimah, he was referred to Dr Punam Bijlani, Head of Department of Plastic and Reconstructive Surgery.

“Even as Mr Thomas was relating his symptoms, I had made a diagnosis. I told him there was a high suspicion of a glomus tumour,” Dr Bijlani said.

According to him, a 'glomus tumour' is a rare benign vascular tumour of the fingers (and other places). It accounts only for a very small percentage of hand tumours. This benign tumour causes considerable morbidity to the patient because of the usual delay in diagnosis. History and careful physical examination helps to narrow down the differential diagnosis. Although the classic triad of severe paroxysmal pain, temperature sensitivity, and point tenderness exists, these may be in varying proportions and some of them may be absent. Many of these tumours are so tiny that they cannot be seen or palpated and sometimes even missed radiologically. A high clinical suspicion is important.

Dr Bijlani said: “Plain radiographs mostly will be normal. Bony erosions usually occur in later stages of the disease. MRI can be useful; however, some of these growths are too small and may not be picked up. 

“Of course not every burning sensation is caused by glomus tumours which are a very uncommon variety but it’s something to keep at the back of our mind for what the mind does not know the eye cannot see. The tumour was surgically excised and relief is complete. The offending tumor was only 3mm in size.

“In the world of technology, we cannot leave behind the value of clinical diagnosis and tacit knowledge for there is no substitution for the wisdom that grey hair provides.

“Further, the much-favoured opinion that plastic surgery is about aesthetics alone needs to be dispelled. Plastic surgery is one of the most ancient branches of medicine. Congenital anomalies, hand surgery, cancer reconstruction, trauma reconstruction and recalcitrant wounds amongst others, all come under the purview of plastic surgeons. Reducing plastic surgery to an aesthetic resource alone is as much a disservice to the faculty as it is to society,” added Dr. Bijlani.



 

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