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Glomus tumours are uncommon, typically benign neoplasms of specialised dermal thermoregulatory structures known as glomus bodies. Wide local excision is the gold standard management for such tumours with good recurrence-free outcomes. Rarely, they may exhibit malignant and metastatic behaviour. The efficacy of systemic treatments to manage widespread or metastatic disease has been trialled with varying degrees of success but remains poorly understood.This case report describes a cutaneous glomus tumour in a female patient. Despite prompt wide local excision of the primary lesion and subsequent nodal recurrence, the patient developed metastatic disease that failed to respond to taxane chemotherapy but was stabilised for several months with selective internal radiation therapy and doxorubicin. She passed away shortly after developing widespread abdominal and bony metastases.This case highlights the potentially aggressive recurrence of glomus tumours, the importance of close follow-up and the challenges of treating lesser understood cancers.