Glomus tumors are rare, usually solitary lesions, most commonly presenting as a painful nodule in the subungual location of the digits. Glomus tumors have been reported in multiples1–3 and can be found in atypical locations, including the lower leg. We describe sonographic and magnetic resonance imaging (MRI) findings in a patient with multiple glomus tumors of the lower leg.
50-year-old woman sought medical care for a 40-year history of pain in her left lower calf and ankle. She had had a large burn to the area from a motorcycle tailpipe at age 10 years. Physical examination revealed very tender swelling deep to her Achilles tendon. There was no discoloration of the skin or skin atrophy to suggest reflex sympathetic dystrophy.
Magnetic resonance imaging was performed, consisting of axial, sagittal, and coronal T1-weighted images and fat-saturated T2-weighted images with 3-plane fat-saturated spoiled gradient echo sequences after gadolinium administration. A well-circumscribed 3 x 2.5-cm mass was seen within the distal flexor hallucis longus muscle belly, which was isointense to muscle on the T1-weighted images (Figure 1A ) and had high T2 signal intensity. Prominent surrounding serpiginous vessels and mild soft tissue edema were noted adjacent to the dominant mass. Two other smaller, more superficial masses were seen close to the large mass. The
Journal of Ultrasound, Case Report by Katrina N. Glazebrook, MBChB, 4/2010