A clear cell sarcoma tumor of the finger with an unusual presentation misdiagnosed as a glomus tumor in an adolescent patient: A case report

Clear cell sarcoma (CCS) is an uncommon malignancy originating from neural crest cells; this type of cancer can mimic a number of other tumors and frequently presents in the lower limbs, but is occasionally found in atypical locations. The present study describes a rare case of a 14‑year‑old girl presenting with a subungual swelling on the right index finger, with the initial impression of a glomus tumor, who underwent unplanned surgical resection at another institution. The histopathological analysis revealed CCS with positive margins, and the patient was therefore referred to an orthopedic oncology specialist King Khalid University Hospital (King Saud University Medical City, Riyadh, Saudi Arabia), for further management. Local and systemic staging workups confirmed localized disease; hence, local control was achieved by amputation at the base of the middle phalanx level, with negative margins achieved without chemotherapy or radiation therapy. Finger tumors may impose diagnostic challenges due to their rarity and similarity with more common benign conditions. A high index of suspicion is important to make an early, accurate diagnosis, and to avoid inappropriate management and poor outcomes. The current case is one of the few published reports of CCS arising in the finger and, to the best of our knowledge, the second pediatric case. Therefore, the present study contributes to the limited literature on CCS presenting in an unusual location such as the hand, with the aim of avoiding errors in diagnosis and management.