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Bouziane W, Amahtil M, Daoudi A. Giant fibrolipoma of the median nerve in the thenar eminence: Case report and literature review. Radiol Case Rep 2023; 18:1518-1521. [PMID: 36824990 PMCID: PMC9941062 DOI: 10.1016/j.radcr.2023.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/04/2023] [Accepted: 01/07/2023] [Indexed: 02/10/2023] Open
Abstract
Nerve fibrolipoma is a very rare benign tumor, corresponding to fibrofatty proliferation of the epineurium and perineurium, where most frequently, the median nerve is touched. We report the case of a 52-year-old patient who has a giant fibrolipoma of the thenar branch of the median nerve evolving at the level of the thenar eminence, an exceptional size and location for this disorder. Our case presents fibrolipoma of the median nerve in thenar eminence, a size and localization that has not been reported in the literature to our knowledge A good dissection makes it possible to obtain total resection without neurological after-effects.
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Affiliation(s)
- Walid Bouziane
- Department of Orthopedic Surgery and Traumatology, University Hospital Oujda, Oujda, Morocco,University Mohammed first Oujda Faculty of Medicine and Pharmacy, Oujda, Morocco,Corresponding author.
| | - Mouncef Amahtil
- Department of Orthopedic Surgery and Traumatology, University Hospital Oujda, Oujda, Morocco,University Mohammed first Oujda Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Abdelkrim Daoudi
- Department of Orthopedic Surgery and Traumatology, University Hospital Oujda, Oujda, Morocco,University Mohammed first Oujda Faculty of Medicine and Pharmacy, Oujda, Morocco
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Serinelli S, Gitto L, Zaccarini DJ. Synovial sarcoma of the hand-wrist: a case report and review of the literature. J Med Case Rep 2021; 15:12. [PMID: 33453728 PMCID: PMC7811743 DOI: 10.1186/s13256-020-02613-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 11/30/2020] [Indexed: 02/07/2023] Open
Abstract
Background Synovial sarcomas are infrequent malignant tumors occurring mostly in adolescents and young adults. The occurrence of synovial sarcoma in the hand-wrist area is rare (4 to 8.5% of all synovial sarcomas in different studies). Case presentation This report documents an uncommon case of synovial sarcoma occurring in the hand-wrist of a 69-year-old Caucasian woman. She was subsequently treated with surgical excision and radiotherapy without recurrence after follow up. Conclusions This paper aims to characterize the demographic, pathologic, and clinical features with a literature review. The present literature review confirms that hand-wrist synovial sarcomas are more frequent among males and subjects 10 to 40 years old. Most cases in this location are usually not larger than 5 cm in size. The five-year survival rate is higher than that reported in a previous review on hand synovial sarcomas, and this suggests an improved survival in recent decades.
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Affiliation(s)
- Serenella Serinelli
- Department of Pathology, State University of New York - Upstate Medical University, 750 E. Adams St, Syracuse, NY, 13210, USA.
| | - Lorenzo Gitto
- Department of Pathology, State University of New York - Upstate Medical University, 750 E. Adams St, Syracuse, NY, 13210, USA
| | - Daniel J Zaccarini
- Department of Pathology, State University of New York - Upstate Medical University, 750 E. Adams St, Syracuse, NY, 13210, USA
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Jalal Y, Bah A, Zaddoug O, Zine A, Jaafar A. Lipomatosis of interdigital nerves: Unusual localization. Foot (Edinb) 2018; 36:21-24. [PMID: 30326348 DOI: 10.1016/j.foot.2018.04.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2017] [Revised: 03/16/2018] [Accepted: 04/23/2018] [Indexed: 02/04/2023]
Abstract
Lipomatosis of the nerve (LN) is a rare benign tumor that is characterized by proliferating fibrous fatty tissue surrounding and infiltrating the peripheral nerves. While there are numerous case reports of LN affecting the median nerve and its branches, there are few reports, to the authors' knowledge, of their occurrence in the foot and ankle. A rare case of LN involving the second and third interdigital nerve in a 41-year-old man, which was successfully treated with surgical excision, is reported.
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Affiliation(s)
- Y Jalal
- Orthopedic Surgery and Traumatology Department, Military Hospital Mohamed V (HMIMV), Faculty of Medicine and Pharmacy of Rabat, BP 10100 Rabat, Morocco.
| | - A Bah
- Orthopedic Surgery and Traumatology Department, Military Hospital Mohamed V (HMIMV), Faculty of Medicine and Pharmacy of Rabat, BP 10100 Rabat, Morocco.
| | - O Zaddoug
- Orthopedic Surgery and Traumatology Department, Military Hospital Mohamed V (HMIMV), Faculty of Medicine and Pharmacy of Rabat, BP 10100 Rabat, Morocco.
| | - A Zine
- Orthopedic Surgery and Traumatology Department, Military Hospital Mohamed V (HMIMV), Faculty of Medicine and Pharmacy of Rabat, BP 10100 Rabat, Morocco.
| | - A Jaafar
- Orthopedic Surgery and Traumatology Department, Military Hospital Mohamed V (HMIMV), Faculty of Medicine and Pharmacy of Rabat, BP 10100 Rabat, Morocco.
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Guillaumon AT, Bosnardo CAF, Meirelles LRD. Glomangioma da artéria digital do polegar: relato de um caso. J Vasc Bras 2012. [DOI: 10.1590/s1677-54492012000400012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Os autores relatam um caso de tumor glômico em ramo da artéria radial que irriga o polegar direito, com história clínica de 4 meses. O doente referia o aparecimento de tumoração de aproximadamente 2,0 centímetros na região interdigital, entre o primeiro e o segundo quirodactilos da mão direita, sobre o músculo flexor curto do polegar, extremamente dolorosa e com dor em progressão. Os exames com aparelho de Doppler bidirecional e o eco-color-Doppler apresentaram, como diagnóstico presuntivo, malformação arteriovenosa, pelo turbilhonamento do fluxo e ausência de estenoses. A tumoração foi retirada por cirurgia aberta e encaminhada para exame histopatológico, com diagnóstico de glomangioma. Este relato descreve uma doença arterial pouco frequente, que causa extremo desconforto ao seu portador, mas que é solucionada pela exerese cirúrgica, sem sequelas.
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Casal D, Ribeiro AI, Mafra M, Azeda C, Mavioso C, Mendes MM, Mouzinho MM. A 63-year-old woman presenting with a synovial sarcoma of the hand: a case report. J Med Case Rep 2012; 6:385. [PMID: 23148739 PMCID: PMC3514372 DOI: 10.1186/1752-1947-6-385] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2012] [Accepted: 10/05/2012] [Indexed: 12/12/2022] Open
Abstract
Introduction Synovial sarcoma is a high-grade, soft-tissue sarcoma that most frequently is located in the vicinity of joints, tendons or bursae, although it can also be found in extra-articular locations. Most patients with synovial sarcoma of the hand are young and have a poor prognosis, as these tumors are locally aggressive and are associated with a relatively high metastasis rate. According to the literature, local recurrence and/or metastatic disease is found in nearly 80% of patients. Current therapy comprises surgery, systemic and limb perfusion chemotherapy, and radiotherapy. However, the 5-year survival rate is estimated to be only around 27% to 55%. Moreover, most authors agree that synovial sarcoma is one of the most commonly misdiagnosed malignancies of soft tissues because of their slow growing pattern, benign radiographic appearance, ability to change size, and the fact that they may elicit pain similar to that caused by common trauma. Case presentation We describe an unusual case of a large synovial sarcoma of the hand in a 63-year-old Caucasian woman followed for 12 years by a multidisciplinary team. In addition, a literature review of the most pertinent aspects of the epidemiology, diagnosis, treatment and prognosis of these patients is presented. Conclusion Awareness of this rare tumor by anyone dealing with hand pathology can hasten diagnosis, and this, in turn, can potentially increase survival. Therefore, a high index of suspicion for this disease should be kept in mind, particularly when evaluating young people, as they are the most commonly affected group.
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Affiliation(s)
- Diogo Casal
- Plastic and Reconstructive Surgery Senior Consultant, São José Hospital, Lisbon, Portugal.
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Romanowski L, Czarnecki P, Brȩborowicz M. Benign and Malignant Hand Tumors. Plast Reconstr Surg 2010. [DOI: 10.1007/978-1-84882-513-0_39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Intraosseous glomus tumor treated by toe-to-finger transfer: case report. J Hand Surg Am 2009; 34:710-4. [PMID: 19345875 DOI: 10.1016/j.jhsa.2009.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2008] [Revised: 12/26/2008] [Accepted: 01/05/2009] [Indexed: 02/02/2023]
Abstract
We report a case of intraosseous glomus tumor that developed in the right ring finger distal phalanx of a 19-year-old man. Clinical and radiographic findings were atypical. The tumor was excised en bloc because of the extensive involvement. The left second toe was transferred to the right ring finger to reconstruct the excised finger part. Symptom relief, function, and cosmetic outcome were satisfactory during 2-year follow-up.
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Toms AP, Anastakis D, Bleakney RR, Marshall TJ. Lipofibromatous Hamartoma of the Upper Extremity: A Review of the Radiologic Findings for 15 Patients. AJR Am J Roentgenol 2006; 186:805-11. [PMID: 16498111 DOI: 10.2214/ajr.04.1717] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to analyze the radiologic characteristics of lipofibromatous hamartomas affecting upper limb peripheral nerves. CONCLUSION Although there are pathognomonic features that characterize lipofibromatous hamartoma on MRI, the range of appearances is broad. Sonography appears to show equally characteristic features and may be a useful tool for assessing this condition.
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Affiliation(s)
- Andoni P Toms
- Department of Radiology, Norfolk and Norwich University Hospital, Colney Ln., Norwich, Norfolk NR4 7UY, England.
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Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 146 peripheral non—neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 2005; 102:256-66. [PMID: 15739553 DOI: 10.3171/jns.2005.102.2.0256] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object. This is a retrospective review of 146 surgically treated benign and malignant peripheral non—neural sheath tumors (PNNSTs). Tumor classifications with patient numbers, locations of benign PNNSTs, and surgical techniques and adjunctive treatments are presented. The results of a literature review regarding tumor frequencies are presented.
Methods. One hundred forty-six patients with 111 benign and 35 malignant PNNSTs were treated between 1969 and 1999 at the Louisiana State University Health Sciences Center (LSUHSC). The benign tumors included 33 ganglion cysts, 16 cases of localized hypertrophic neuropathy, 12 lipomas, 12 tumors of vascular origin, and 11 desmoid tumors. There were four each of lipofibrohamartomas, myositis ossificans, osteochondromas, and ganglioneuromas; two each of meningiomas, cystic hygromas, myoblastoma or granular cell tumors, triton tumors, and lymphangiomas; and one epidermoid cyst. The locations of benign PNNSTs were the following: 33 in the brachial plexus region, 39 in an upper extremity, one in the pelvic plexus, and 38 in a lower extremity.
The malignant PNNSTs included 35 surgically treated carcinomas, 15 of which originated in the breast and nine in the lung. There were two melanomas metastatic to nerve and one tumor each that had metastasized from the bladder, rectum, skin, head and neck, and thyroid, and from a primary Ewing sarcoma. There was a single lymphoma that had metastasized to the radial nerve and one chordoma and one osteosarcoma, each of which had metastasized to the brachial plexus.
Conclusions. There were more benign PNNSTs than malignant ones. Benign tumors were relatively equally distributed in the brachial plexus region and upper and lower extremities, with the exception of the pelvic plexus, which had only one tumor.
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Affiliation(s)
- Daniel H Kim
- Department of Neurosurgery, Stanford University Medical Center, Stanford, California 94305-5327, USA.
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Davila JA, Amrami KK, Sundaram M, Adkins MC, Unni KK. Chondroblastoma of the hands and feet. Skeletal Radiol 2004; 33:582-7. [PMID: 15316680 DOI: 10.1007/s00256-004-0762-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2003] [Revised: 02/04/2004] [Accepted: 02/05/2004] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To review the imaging findings, age and gender distribution of chondroblastoma of the hands and feet. DESIGN AND PATIENTS Twenty-five cases of pathologically proven chondroblastoma of the hands and feet were reviewed. Available imaging modalities included radiographs (n=24), CT (n=3), MRI (n=5), and radionuclide bone scintigraphy (n=1). The following imaging features for each case were tabulated: location, presence of sclerotic margin, calcification, expansion, presence of fluid/fluid levels on cross-sectional imaging and surrounding edema on MRI. The images were evaluated for skeletal maturity using closure of the physeal plate in the region as a standard. RESULTS The average age at time of diagnosis was 23 years (range 7-57 years). Eighty-four percent (n=21) of the patients were skeletally mature. Males (20 of 25) outnumbered females by a ratio of 5:1. The bones of the foot accounted for 22 cases: calcaneus (n=8), talus (n=8), metatarsals (n=3), and the cuboid (n=3). The bones of the hand accounted for three cases: phalanx (n=1), triquetrum (n=1), and a metacarpal (n=1). Radiographically all lesions were osteolytic with identifiable calcification in 54% (13 of 24). Fluid/fluid levels were seen in four of five cases on MRI. Edema on MR images was seen in 40% (2 of 5). The size of the lesions ranged from 2 to 41 cm(2). CONCLUSION Chondroblastomas of the hands and feet share many of the radiographic characteristics seen in the long bones, but manifest in skeletally mature patients with a higher male to female ratio than in long bone chondroblastoma. Talar and calcaneal lesions were encountered only in males. Chondroblastoma of the wrist and hand appears to be exceptionally rare.
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Affiliation(s)
- Jesse A Davila
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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A large Guyon's canal lipoma without neuropathy in a child. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2004; 14:161-4. [PMID: 27517183 DOI: 10.1007/s00590-004-0159-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2004] [Accepted: 05/26/2004] [Indexed: 10/26/2022]
Abstract
Lipomas originating from Guyon's canal are uncommon tumors. There are rare reports of adult cases, often with nerve compression findings. However, so far, no report had described this tumor in the pediatric age group. This article presents an 8-year-old boy who presented with a 3-year history of slowly growing hypothenar mass. Exploration yielded a large lipoma (35×55×44 mm) originating from the proximal Guyon's canal, which resides within the hypothenar musculature. The lesion was excised totally, and histological evaluation confirmed the diagnosis. The follow-up period was uneventful, and complete cure was attained. To the best of our knowledge, this is the first report of a lipoma deriving from the Guyon's canal in a child. Despite its huge mass, no signs of nerve compression were detected. This inconsistency between children and adult patients may be due to anatomical and physiological differences of the Guyon's canal and attending nerves and muscles. In children, the structures forming the canal may be more expandable to let such a bulk grow without neuropathy.
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Abstract
A patient presented with a glomangioma that presented as an aneurysm of the superficial palmar arch. Throbbing pain, tenderness over the tumor, and cold intolerance were clinical features. Cold intolerance was the major problem. The pathologic diagnosis was glomangioma. Excision of the tumor provided a good result and there has been no recurrence.
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Affiliation(s)
- Masayuki Kamano
- Department of Orthopaedic Surgery, Baba Memorial Hospital, Osaka, Japan.
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