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Glomus Tumour Excision

34 citationsUpdated Oct 2026
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Overview

Glomus tumours are uncommon soft tissue neoplasms of the extremities that are frequently dismissed by clinicians, resulting in prolonged diagnostic delays regardless of tumor location [1, 7]. This rare condition was encountered in 0.26% of patients (8 of 3014) referring for hand surgery over a 10-year period [9]. While often misdiagnosed and subjected to various non-surgical interventions before definitive care [8], glomus tumor represents one of the most painful clinical conditions confirmed by comprehensive assessment [4]. Multiple digital glomus tumors constitute a definite entity, occurring in seven of 28 patients in one series [5].

Surgical excision remains the treatment of choice, providing excellent pain relief with minimal complications and no recurrence in reported series [2]. Once identified, these tumors can be effectively treated with complete excision [3]. Surgical excision was curative with minimal risk of recurrence [11], and in all instances of one study, although one patient required a second procedure for complete excision [13]. Careful dissection and complete excision almost always offer permanent relief [17]. Specific techniques, such as the transungual approach, have resulted in complete symptom improvement without recurrences [14], and the Microscopic Transungual Surgical Approach demonstrates potential efficacy [12]. The described technique allows simple access to tumors under the proximal nail bed with minimal defect [16].

High magnification with an operative microscope is essential and must be used routinely during excision, especially in the distal phalanx, to prevent recurrence [18]. Regarding pre-operative imaging, failure to diagnose glomus tumors on MRI is associated with smaller tumor size, atypical pathology, and atypical location [26]. Based on study results and the cost of MRI, the senior author has stopped ordering pre-operative MRIs in patients clinically diagnosed with a glomus tumour [19].

Anatomy & Pathophysiology

Glomus Body Physiology and Tumor Origin

Glomus tumours are benign neoplasms that originate from the glomus body [23]. The glomus body is a neuromyoarterial structure that regulates blood pressure and temperature through regulation of blood flow in the cutaneous vasculature [23]. Consequently, glomus tumors develop within the glomus neuro-myo-arterial system [15].

Anatomical Distribution and Prevalence

Glomus tumours are a rare entity that most commonly affect the fingertips of the digits [20]. This uncommon soft tissue neoplasm commonly occurs in the extremities [7]. Specifically, glomus tumors are benign, rare tumors, representing approximately 5% of soft tissue tumors of the hand [15], and the glomus tumour accounts for 1%–5% of all hand tumours [23]. The most common location for glomus tumours is the distal segment of the fingers [23]. The neoplasm most commonly occurs in the subungual area, where abundant glomus bodies are present [23]. Glomus tumors mostly occur in the hand at the subungual region [15]. Seventy-five to ninety percent of glomus tumours are located in the subungual region because of a high concentration of glomus bodies [38]. Glomus tumours can also occur in the periungual or pulp areas [23].

Clinical Presentation and Diagnostic Challenges

Pain is the most common symptom, with 66 patients (90%) presenting with paroxysmal pain and pain on pressure [20]. Pain related to cold sensation is the next most common symptom after paroxysmal pain and pain on pressure [20]. Only 10 patients (14%) described pain related to changes in temperature [20]. Glomus tumor is one of the most painful clinical conditions confirmed by comprehensive clinical assessment [4]. These subcutaneous, mostly subungual, nodules have a disproportionate negative impact despite their small size [24]. Symptoms are often unclear, even when there is significant pain, and diagnosis is often late [15]. Chronic pain evolves in the upper limb and causes disability and handicap [15]. Glomus tumour may be easily dismissed by clinicians, resulting in a prolonged period before the right diagnosis is made [7]. Subungual glomus tumours have characteristic clinical presentation [21]. The clinical diagnosis is based on spontaneous pain with proximal radiation, pain during immersion in cold water, pain upon touching the lesion by a blunt tip (Love’s sign), and positive Hildreth’s sign where symptoms are abolished by proximal tourniquet inflation [37].

Histopathology and Tumor Characteristics

The mean size of the glomus tumours on pathological examination was 5.7 mm (range 215) [20]. In a series of 11 cases, the histological aspect of the tumors was typically benign, with no multiple locations or degenerative malignancy observed [32]. Multiple digital glomus tumors are a definite entity, occurring in seven of 28 patients in a specific series [5]. Tumours in 14 (19%) patients occurred in a region of the hand that had previously suffered trauma [20].

Classification

Epidemiology and Origin: Glomus tumours account for 1%–5% of all hand tumours [23]. These benign neoplasms originate from the glomus body, a neuromyoarterial structure that regulates blood pressure and temperature by controlling blood flow within the cutaneous vasculature [23].

Anatomic Distribution: The distal segment of the fingers represents the most common location for glomus tumors [23]. These subcutaneous, mostly subungual nodules demonstrate a predominance on the ring finger [24]. Additionally, glomus tumors can occur in the periungual or pulp areas [23].

Other Considerations: Glomus tumors are often misdiagnosed, leading to various non-surgical treatment options before definitive surgical intervention [8]. Diagnosis is frequently delayed, resulting in patients being misdiagnosed for months or even years [15]. The continued importance of clinical suspicion in diagnosis is highlighted by findings regarding tumors not diagnosed on MRI [6].

Clinical Presentation

Epidemiology and Demographics

Glomus tumors represent approximately 5% of soft tissue tumors of the hand [15] and account for 1%–5% of all hand tumours [23]. In a series of 73 patients, the mean age was 49 years (range 16-91) [20]. The cohort comprised 31 women and 43 men [20].

Anatomical Location

These neoplasms develop within the glomus neuro-myo-arterial system, mostly in the hand at the subungual region [15]. The tumor most commonly occurs in the subungual area, where abundant glomus bodies are present, but it can also occur in the periungual or pulp areas [23]. In a series of 73 patients, tumours were mostly located in the subungual/nail bed region and fingertip/pulp [20]. Glomus tumors commonly occur in the extremities [7]. Subcutaneous, mostly subungual nodules have a predominance on the ring finger [24].

Symptoms and Signs

Pain is the most common symptom, with 66 patients (90%) presenting with paroxysmal pain and pain on pressure in a series of 73 patients [20]. Pain related to cold sensation was the next most common symptom in this series [20]. Only 10 patients (14%) described pain related to changes in temperature [20]. Glomus tumor is one of the most painful clinical conditions [4]. Symptoms are often unclear, even when there is significant pain [15]. Despite their small size, glomus tumors have a disproportionate negative impact [24].

Diagnostic Challenges

Glomus tumours may pose a diagnostic challenge even to hand surgeons [20]. Awareness of the diagnosis and application of Hildreth's test should reduce delay and mis-diagnosis in the management of glomus tumours [27].

Multiple Tumors

In a series of 11 cases, no multiple locations were observed [32].

Investigations

Clinical Examination

Symptoms are often unclear, even when there is significant pain, and diagnosis is often late, causing many patients to be misdiagnosed for months or even years [15]. A careful preoperative and intraoperative examination for synchronous lesions should be made, and patients should be informed of the risk of recurrent symptoms [28].

Imaging

These findings highlight the continued importance of clinical suspicion in glomus tumor diagnosis [6].

Treatment

Non-Operative

The provided evidence does not support specific conservative management options such as weight loss, physical therapy, NSAIDs, or injections for glomus tumors.

Operative

Indications: Surgical excision is the treatment of choice and reference standard for glomus tumors [2, 15]. Once identified, these tumors can be effectively treated with complete excision [3].

Surgical Approach / Technique: Complete surgical excision is curative with minimal risk of recurrence [11] and provides excellent pain relief [2]. Careful dissection and complete excision almost always offer permanent relief [17], curing the condition dramatically [4]. In a series of digital glomus tumors, surgical excision was curative in all instances, although one patient required a second procedure for complete excision [13].

Operative Technique and Magnification: High magnification with an operative microscope is essential and must be used routinely during excision, especially in the distal phalanx, to prevent recurrence [18]. In a multicentre study, surgical excision was performed under loupe magnifier or microscopy [23]. For peripheral subungual tumors, a periungual incision shaped like a shark’s mouth is made and continued down to the distal phalanx to elevate a dorsal flap containing the skin, nail bed, and germinal matrix [37]. For centrally located subungual tumors, a transungual approach is used where an opening equivalent in size to one quarter of the nail is made in front of the tumor [37]. If a glomus tumor has invaded the phalanx, curettage is needed during excision [38].

Approach Variants: A transungual approach with careful dissection using an operating microscope produces good results with complete symptom relief, no local recurrence, and no cosmetically unacceptable nail deformity [29]. A microscopic transungual surgical approach has potential efficacy in treating glomus tumors [12]. A transungual approach with partial proximal nail avulsion helps in proper growth of the nail as there are no chances of distal nail embedding [39]. A surgical technique described for approaching a glomus tumour under the proximal nail bed produces a minimal defect [16]. In a study of subungual glomus tumors, no new nail deformity was found with the utilized approach [30].

Lateral-Ungual Approach: A lateral-ungual approach involving a full thickness nail bed flap or finger pulp flap raised subperiosteally was used to remove glomus tumors in eight patients [38]. In this approach, the glomus tumor is carefully separated and resected under the microscope to limit damage to the nail bed [38]. The incision is closed with interrupted 8-0 absorbable sutures, and the nail bed is covered with oil carbasus after closure [38].

Outcomes and Complications: No patient experienced a wound infection or a nail deformity following the lateral-ungual approach with nail bed or pulp flap [38]. Pain was significantly improved and all patients recovered normal function in 3 weeks following the lateral-ungual approach [38].

Complications

Recurrence: The transungual approach with careful dissection using an operating microscope produces good results with complete symptom relief and no local recurrence [29]. A lateral surgical approach with careful matriectomy is effective in most cases, with minimal recurrence [25]. The ‘shark mouth’ flap approach for digital glomus tumours achieves satisfactory clinical outcomes with a low recurrence rate [40].

Nail Deformity: In four cases within the nail restored group, there was no nail deformity [22]. Contrary to reported literature, no new nail deformity developed with this approach [30]. The ‘shark mouth’ flap approach for digital glomus tumours achieves satisfactory clinical outcomes with no new nail deformities [40].

Recovery

Other Considerations: Surgical excision provides excellent pain relief with minimal complications and no recurrence [2]. Glomus tumors can be effectively treated with complete excision [3], and complete surgical excision dramatically cures glomus tumors [4]. The described surgical technique for approaching a glomus tumour under the proximal nail bed produces a minimal defect [16]. Chronic pain from glomus tumors evolves in the upper limb and causes disability and handicap [15]. Surgical management of glomus tumors improves quality of life [15].

Key Evidence

  • [Paper] Glomus tumors of the hand are associated with prolonged diagnostic delay regardless of tumor location. [1] (10.7759/cureus.107434)
  • [Paper] Surgical excision remains the treatment of choice, providing excellent pain relief with minimal complications and no recurrence in this series. [2] (10.13107/jocr.2026.v16.i10.8284)
  • [Paper] Once identified, glomus tumors can be effectively treated with complete excision. [3] (10.7759/cureus.86227)
  • [Paper] Glomus tumor is one of the most painful clinical conditions confirmed by comprehensive clinical assessment and cured dramatically by complete surgical excision. [4] (10.4103/jfmpc.jfmpc_446_20)
  • [L4] Multiple digital glomus tumors are a definite entity, occurring in seven of 28 patients in this series. [5] (10.1016/s0363-5023(79)80076-3)
  • [L4] These findings highlight the continued importance of clinical suspicion in glomus tumor diagnosis. [6] (10.1016/j.jhsa.2014.12.002)
  • [L4] Glomus tumour is an uncommon soft tissue neoplasm that commonly occurs in the extremities and may be easily dismissed by clinicians, resulting in a prolonged period before the right diagnosis is made. [7] (10.1186/s13018-023-04234-1)
  • [L4] Glomus tumours are often misdiagnosed and are intervened with different treatment options before being surgically intervened. [8] (10.4103/jwas.jwas_171_22)
  • [L4] Glomus tumor is a rare disease, encountered in 0.26% of patients (8 of 3014) referring for hand surgery over a 10-year period. [9] (10.1097/bth.0b013e3181c767d4)
  • [Paper] Surgical excision of glomus tumors was curative with minimal risk of recurrence. [11] (10.4103/idoj.idoj_786_24)
  • [Paper] Our study suggests the potential efficacy of the Microscopic Transungual Surgical Approach in treating glomus tumors. [12] (10.3389/fmed.2025.1607299)
  • [L4] Surgical excision was curative in all instances, although one patient required a second procedure for complete excision. [13] (10.1016/s0363-5023(77)80121-4)
  • [Paper] Excision of glomus tumors through a transungual approach resulted in the complete improvement of symptoms without recurrences. [14] (10.1016/j.jpra.2020.09.004)
  • [L4] [15] (10.1016/j.main.2014.07.001)
  • [L4] With the described surgical technique, it is simple to approach a glomus tumour under the proximal nail bed and it produces a minimal defect. [16] (10.1016/s0266-7681(97)80069-1)
  • [L4] Careful dissection and complete excision of the tumour almost always offer permanent relief. [17] (10.1016/s0266-7681(96)80110-0)
  • [Paper] High magnification with operative microscope is essential and has to be used routinely during the excision of glomus tumor especially in the distal phalanx in order to prevent recurrence. [18] (10.4103/jcas.jcas_161_21)
  • [L4] Based on the results of the current study and the cost of MRI, the senior author has stopped ordering pre-operative MRIs in patients clinically diagnosed with a glomus tumour. [19] (10.1016/j.jhsb.2005.06.009)
  • [L4] [20] (10.1177/17531934211049632)
  • [Paper] Subungual glomus tumours have characteristic clinical presentation. [21] (10.4103/0974-2077.123401)
  • [L4] In four cases in the nail restored group, there was no nail deformity. [22] (10.1016/0363-5023(94)90070-1)
  • [L4] [23] (10.1177/1753193418774176)
  • [L4] These subcutaneous, mostly subungual, nodules, with predominance on the ring finger, have a disproportionate negative impact despite their small size. [24] (10.1016/j.hansur.2017.04.002)
  • [Paper] A lateral surgical approach with careful matriectomy was effective in most cases, with minimal recurrence. [25] (10.7759/cureus.85869)
  • [L4] Failure to diagnose glomus tumors on MRI is associated with smaller tumor size, atypical glomus tumor pathology, and atypical location. [26] (10.1016/j.jhsa.2014.06.096)
  • [L2] Awareness of the diagnosis and application of Hildreth's test should reduce delay and mis-diagnosis in the management of glomus tumours. [27] (10.1054/jhsb.2001.0724)
  • [L4] A careful preoperative and intraoperative examination for synchronous lesions should be made, and patients should be informed of the risk of recurrent symptoms. [28] (10.1016/j.jhsa.2010.02.019)
  • [L4] The transungual approach with careful dissection using an operating microscope produced good results with complete symptom relief, no local recurrence, and no cosmetically unacceptable nail deformity. [29] (10.1177/1753193408104799)
  • [Paper] Contrary to reported literature, we did not find the development of any new nail deformity with this approach. [30] (10.4103/0019-5413.159611)
  • [L4] In this series of 11 cases, the histological aspect of the tumors was typically benign, with no multiple locations or degenerative malignancy observed. [32] (10.1016/s1297-3203(00)73487-1)
  • [L3] [37] (10.1016/j.main.2014.09.006)
  • [L4] [38] (10.1177/1753193410397980)
  • [Paper] It also helps in proper growth of nail as there are no chances of distal nail embedding in the case of proximal nail avulsion as in our case. [39] (10.4103/0974-2077.191654)
  • [L4] It achieves satisfactory clinical outcomes with no new nail deformities and a low recurrence rate. [40] (10.1177/1753193419867049)

See Also

References

[1] Diagnostic Delay and Clinical Characteristics of Glomus Tumors in the Hand: A Case Series of 11 Patients. Cureus. 2026. DOI: 10.7759/cureus.107434

[2] Early Recognition of Glomus Tumor of Hand Using Clinical Tests: Experience from an Indian Tertiary Center. Journal of Orthopaedic Case Reports. 2026. DOI: 10.13107/jocr.2026.v16.i10.8284

[3] Management of Glomus Tumors: Experience From a Tertiary Care Centre in India. Cureus. 2025. DOI: 10.7759/cureus.86227

[4] Digital glomus tumor: An experience of 57 cases over 20 years. Journal of Family Medicine and Primary Care. 2020. DOI: 10.4103/jfmpc.jfmpc_446_20

[5] Multiple digital glomus tumors. The Journal of Hand Surgery. 1979. DOI: 10.1016/s0363-5023(79)80076-3

[6] Characteristics of Glomus Tumors in the Hand Not Diagnosed on Magnetic Resonance Imaging. The Journal of Hand Surgery. 2015. DOI: 10.1016/j.jhsa.2014.12.002

[7] Glomus tumour: an institutional experience of 31 cases. Journal of Orthopaedic Surgery and Research. 2023. DOI: 10.1186/s13018-023-04234-1

[8] Glomus Tumour of Hand––A Commonly Misdiagnosed Pathology. Journal of West African College of Surgeons. 2022. DOI: 10.4103/jwas.jwas_171_22

[9] Diagnosis and Management of Glomus Tumors of the Hand. Techniques in Hand & Upper Extremity Surgery. 2010. DOI: 10.1097/bth.0b013e3181c767d4

[11] Clinico-epidemiological Characteristics and Long-term Surgical Outcomes in Patients with Glomus Tumor: A Retrospective Study. Indian Dermatology Online Journal. 2025. DOI: 10.4103/idoj.idoj_786_24

[12] A microscopic transungual surgical approach for subungual glomus tumor resection. Frontiers in Medicine. 2025. DOI: 10.3389/fmed.2025.1607299

[13] Glomus tumor of the digits. The Journal of Hand Surgery. 1977. DOI: 10.1016/s0363-5023(77)80121-4

[14] Outcome of transungual surgical approach with synthetic nail shield in the treatment of digital glomus tumors: A retrospective study. JPRAS Open. 2020. DOI: 10.1016/j.jpra.2020.09.004

[15] Improvement in quality of life after surgery for glomus tumors of the fingers. Chirurgie de la Main. 2014. DOI: 10.1016/j.main.2014.07.001

[16] Subungual Glomus Tumours: A Different Approach to Diagnosis and Treatment. Journal of Hand Surgery. 1997. DOI: 10.1016/s0266-7681(97)80069-1

[17] Glomus Tumours of the Hand. Journal of Hand Surgery. 1996. DOI: 10.1016/s0266-7681(96)80110-0

[18] Role of high magnification using operative microscope in surgical clearance of glomus tumor in distal phalanx: An experience of 13 cases. Journal of Cutaneous and Aesthetic Surgery. 2022. DOI: 10.4103/jcas.jcas_161_21

[19] Magnetic Resonance Imaging in the Diagnosis of Glomus Tumours of the Hand. Journal of Hand Surgery. 2005. DOI: 10.1016/j.jhsb.2005.06.009

[20] Glomus tumours of the upper limb and hand. A clinicopathological review of cases over two decades. Journal of Hand Surgery (European Volume). 2021. DOI: 10.1177/17531934211049632

[21] Transungual surgical excision of subungual glomus tumour. Journal of Cutaneous and Aesthetic Surgery. 2013. DOI: 10.4103/0974-2077.123401

[22] Prevention of postoperative nail deformity after subungual glomus resection. The Journal of Hand Surgery. 1994. DOI: 10.1016/0363-5023(94)90070-1

[23] Factors affecting surgical outcomes of digital glomus tumour: a multicentre study. Journal of Hand Surgery (European Volume). 2018. DOI: 10.1177/1753193418774176

[24] Glomus tumors of the upper limb: Single-center retrospective study of clinical and functional outcomes. Hand Surgery and Rehabilitation. 2017. DOI: 10.1016/j.hansur.2017.04.002

[25] Lateral Surgical Approach for Subungual Glomus Tumors With Low Recurrence Rates: A Single-Center Case Series. Cureus. 2025. DOI: 10.7759/cureus.85869

[26] Characteristics of Glomus Tumors in the Hand Missed on MRI. The Journal of Hand Surgery. 2014. DOI: 10.1016/j.jhsa.2014.06.096

[27] Hildreth’s Test is a Reliable Clinical Sign for the Diagnosis of Glomus Tumours. Journal of Hand Surgery. 2002. DOI: 10.1054/jhsb.2001.0724

[28] The Anatomic Location of Digital Glomus Tumor Recurrences. The Journal of Hand Surgery. 2010. DOI: 10.1016/j.jhsa.2010.02.019

[29] Subungual glomus tumours of the hand: diagnosis and outcome of the transungual approach. Journal of Hand Surgery (European Volume). 2009. DOI: 10.1177/1753193408104799

[30] Subungual glomus tumors of the hand. Indian Journal of Orthopaedics. 2015. DOI: 10.4103/0019-5413.159611

[32] Glomus tumors: report on eleven cases and a review of the literature. Chirurgie de la Main. 2000. DOI: 10.1016/s1297-3203(00)73487-1

[37] Which approach is best for subungual glomus tumors? Transungual with microsurgical dissection of the nail bed or periungual?. Chirurgie de la Main. 2015. DOI: 10.1016/j.main.2014.09.006

[38] The treatment of finger glomus tumours by raising a full thickness nail bed flap or finger pulp flap. Journal of Hand Surgery (European Volume). 2011. DOI: 10.1177/1753193410397980

[39] Subungual glomus tumour excision with transungual approach with partial proximal nail avulsion. Journal of Cutaneous and Aesthetic Surgery. 2016. DOI: 10.4103/0974-2077.191654

[40] The ‘shark mouth’ flap approach for digital glomus tumours in 24 patients: technique and clinical outcomes. Journal of Hand Surgery (European Volume). 2019. DOI: 10.1177/1753193419867049

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2. You may satisfy the conditions in Section 3(a)(1) in any reasonable manner based on the medium, means, and context in which You Share the Licensed Material. For example, it may be reasonable to satisfy the conditions by providing a URI or hyperlink to a resource that includes the required information.

3. If requested by the Licensor, You must remove any of the information required by Section 3(a)(1)(A) to the extent reasonably practicable.

4. If You Share Adapted Material You produce, the Adapter's License You apply must not prevent recipients of the Adapted Material from complying with this Public License.

Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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