Benign Painful Soft Tissue Tumors of the Digits: A Contemporary Review

Authors

• Nethmi Withanage, Department of Orthopaedics and Rehabilitation Stony Brook University
• Athikur Rahman, Department of Orthopaedics and Rehabilitation, Stony Brook University
• Lawrence Hurst, Department of Orthopaedics and Rehabilitation, Stony Brook University
• Samantha Muhlrad, Department of Orthopaedics and Rehabilitation, Stony Brook University

Keywords

Orthopaedic surgery; surgical retraction; 3D printing; fracture fixation; medical device design

Abstract

Purpose: Benign painful tumors of the digit are commonly encountered in hand surgery yet frequently pose diagnostic challenges due to overlapping clinical presentations. This review synthesizes current evidence on eight benign soft tissue tumors and cystic lesions that commonly cause digital pain: glomus tumor, giant cell tumor of the tendon sheath (GCTTS), digital mucous cyst, digital ganglion cyst, epidermoid inclusion cyst, pyogenic granuloma, nerve sheath tumors, and angioleiomyoma.

Methods: A comprehensive review of PubMed/MEDLINE was performed, supplemented by hand surgery textbooks and online educational resources. Case series, retrospective cohort studies, and review articles were included.

Results: Each tumor exhibits a characteristic pain profile and anatomic predilection that guides preoperative diagnosis. Glomus tumors produce paroxysmal, cold-triggered subungual pain. Angioleiomyomas cause deep aching pain that intensifies with activity. GCTTS and nerve sheath tumors produce mechanical and neuropathic pain,respectively. Remaining lesions are generally less painful unless complicated by inflammation, infection, or by direct pressure on lesion. Surgical excision is a definitive treatment for these tumors. In a single-institution series of 74 GCTTS cases, the recurrence rate was 15%, with bone and neurovascular bundle involvement as the only significant predictors.⁷

Conclusions: A systematic approach incorporating history, examination, and targeted imaging permits accurate preoperative diagnosis in most cases. The characteristic pain profile of each tumor serves as a valuable diagnostic discriminator, and for GCTTS, preoperative identification of bone and neurovascular involvement is essential for surgical counseling regarding potential recurrence.

Type of Study/Level of Evidence: Therapeutic V (Review Article)

Key Words: Glomus tumor, giant cell tumor of tendon sheath, mucous cyst, digital ganglion cyst, epidermoid inclusion cyst, pyogenic granuloma, schwannoma, angioleiomyoma, benign tumor, digit, finger, painful mass

Disclosure Statement

All authors declare that they have no conflicts of interest.

Corresponding Author

Samantha Muhlrad, MD

[email protected]

Recommended Citation

Withanage, Nethmi; Rahman, Athikur; Hurst, Lawrence; and Muhlrad, Samantha (2026) "Benign Painful Soft Tissue Tumors of the Digits: A Contemporary Review," Stony Brook Orthopaedic and Musculoskeletal Journal: Vol. 6, Article 4.
DOI: https://doi.org/10.31259/3065-2677.1046
Available at: https://commons.library.stonybrook.edu/orthomusculoskeletaljournal/vol6/iss1/4