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Glomus tumor is a rare, benign vascular neoplasm originating from the modified smooth muscle cells of the vascular glomus. Intraosseous glomus tumor, which arises primarily within bone, is even rarer. About 20 cases have been reported in the English literature since 1939, but we could not find any report in the Korean literature. We present the case of a 69-year-old woman with glomus tumor primarily in the distal phalanx of the left second finger. This patient had complained of pain at the tip of her left second finger for about 2 years. She had taken excision twice, with an impression of neuroma on the plain radiograph of the local hospital. But the pain had persisted and let her visit our department. There was no specific problem on her past medical history. On physical examination, she had direct tenderness over the distal phalanx of the left second finger. There was no swelling, soft tissue mass, or signs of inflammation. Radiographs of the left second finger revealed a radiopaque ovoid osteolytic lesion with an outer complete, thin shell of bone measuring 0.5×0.4 cm in size. On T1-weighted magnetic resonance image, a highly enhanced round mass was seen. The initial diagnosis was benign soft tissue tumor. A surgical exploration for complete excision was performed. On histological examination, the tumor was mostly composed of round to ovoid cells that formed nest, short chords and trabeculae, and the nuclei of the cells were round to ovoid with a fine, bland chromatin pattern, and absent to small nucleoli. The cells had clear to pale eosinophilic cytoplasm. On immunohistochemical studies, the tumor cells showed positivity for smooth muscle actin and vimentin. So, the histologic features and special stains confirmed the diagnosis of glomus tumor. The pain disappeared immediately after surgery. The patient remains healthy 4 months since resection of the tumor.
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