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The glomus tumor is a benign growth of the neuromyoarterial canal system of the skin glomus body, which in its normal function controls local regulation of blood pressure and flow. Abnormal proliferation of this tissue generally results in small, well-circumscribed lesions most frequently occurring in the deep dermal or subcutaneous tissues of the extremities that are characterized clinically by aching pain, well-localized tenderness, and temperature sensitivity.
Although the diagnosis of a glomus tumor is readily suspected when the tumor is located in the classic subungual location, deeper subcutaneous lesions occurring more proximally on the extremities can elude accurate diagnosis. This article reports on the second known case of a buttock glomus tumor,1 the location and presentation of which were highly suggestive of ischial bursitis. While well noted in the literature to mimic other localized painful conditions of the ankle,2 foot,3 knee,46 and thigh,7 it has not been included in the differential diagnosis of painful lesions of the buttocks or ischial tuberosity.
CASE REPORT
A healthy 40-year-old man presented with a 20-year history of right buttock pain. The pain had recemly increased significanüy in intensity, coincident with the patient spending a markedly increased number of hours moving on a rolling stool. The patient denied trauma to the region and had no otiier sites of pain. The patient could localize the pain directly over die ischial tuberosity without radiation. The pain was not temperature dependent. On physical examination, no wasting in the extremity and no range-of-motion deficit was noted in die hip. No lesions were noted in the skin or subcutaneous tissue.
The provisional diagnosis of ischial bursitis was made, and the patient was treated with nonsteroidal anti-inflammatory medications and instructed to avoid prolonged sitting. After a 3-month interval without resolution or change in physical examination, the area of tenderness was injected with a lidocaine/cortisone...