Fingernail Preservation in Trans-ungual Excision of Subungual Glomus Tumor

Background: Glomus body tumor is a form of benign neuromyoarterial tumor typically determined in fingers, especially in subungual locations, this tumor is usually removed most effectively by surgical operation. This study aimed to assess the trans-ungual removal of subungual glomus tumor to avoid a postoperative fingernail deformity and a recurrence of subungual glomus body tumors. Methods: This study included 15 patients who underwent trans-ungual surgical microscopic or Loupe magnification to gain micro excision to prevent recurrence and prevent postoperative nail deformity, with follow-up for three years between 2020-2023. Pinpoint pain, cold intolerance, nail discoloration, and deformity all complications were recorded before and after surgery. The diagnosis of glomus was confirmed after histopathology of the excisional biopsy. Results: All of our patients had pinpoint pain, and tenderness, with significant cold intolerance, 12 patients (80%) had obvious nail discoloration, 5 patients (33.33%) had obvious dystrophic changes and three patients (20%) had recurrent glomus tumors. The tumors after microdissection from surrounding tissues usually had an ovoid appearance about 2–10 mm in size. In all our patients, the pain and cold intolerance were declined. The mean follow-up time was 20.13 months, without any tumor recurrences and improvement of the nail shape. None of our patients had postoperative significant nail deformity. Conclusion: Surgical resection for the glomus body tumors via a trans-ungual technique and approach resulted in complete symptom relief with no recurrences and no nail deformity