Delayed Diagnosis of a Subungual Glomus Tumor of the Right Ring Finger Successfully Treated With Nail Apparatus Preservation

Subungual glomus tumors are rare benign vascular neoplasms arising from the neuromyoarterial glomus body. Despite a characteristic clinical triad of severe localized pain, point tenderness, and cold hypersensitivity, prolonged diagnostic delay is common and represents a significant source of patient morbidity. A 39-year-old male presented with a 10-year history of severe subungual pain in the right ring finger that remained undiagnosed across multiple consultations with different specialists. Plain radiography excluded bony involvement, and MRI confirmed a well-defined T2-hyperintense subungual lesion consistent with a glomus tumor. Complete excision was performed via a transungual approach with full nail apparatus preservation. Histopathology confirmed a benign glomus tumor (glomangioma) with diffuse smooth muscle actin positivity. The patient was pain-free at the six-month follow-up with no recurrence. This case underscores the importance of clinical vigilance in patients with chronic unexplained fingertip pain. Early application of the Love and Hildreth tests, followed by MRI, enables timely diagnosis. Complete surgical excision with nail preservation achieves excellent functional and cosmetic outcomes and prevents years of unnecessary patient suffering.