Deep palmar tumorous conditions of the hand

The Simultaneous Compression of the Median and Ulnar Nerves by Lipoma: A Case Report and Review of the Literature

Entrapment syndromes in the hand are very common and usually idiopathic. However, it can be the expression of nerve compression by a nearby structure or tumor. Space-occupying lesions are widely reported as a cause of median or ulnar nerve compression in the wrist. Nevertheless, a simultaneous compression of the median and ulnar nerves by a tumor is a rare condition. To the best of our knowledge, only three cases are described in the English literature. Herein, we present a case of a simultaneous compression in the wrist of the median and ulnar nerves by lipoma in a 79-year-old patient while also elucidating the reasons for the rarity of this condition and reviewing its clinical and therapeutic particularities.

Calcifying Aponeurotic Fibroma of Leg Masquerading as Hemangioma in an Adolescent Male along with Review of Literature

Calcifying aponeurotic fibroma (CAF) is a rare soft tissue tumor which falls under the WHO category of benign fibroblastic and myofibroblastic tumors. It typically occurs on the distal extremities (hands and foot) of children and adolescents. Other less common sites include wrists, ankles, trunk and rarely legs and arms. These tumors present as a painless soft tissue mass, arising in the subcutis, and are usually connected to tendons or aponeuroses. Computed tomography (CT) and magnetic resonance imaging (MRI) are the radiological investigations of choice; however, histopathology remains the diagnostic modality of choice for the diagnosis of CAF. We present a rare case of a 17-year-old boy who presented with a gradually progressive mass lesion on the leg which was later diagnosed as calcifying aponeurotic fibroma on histopathology.

A bump: what to do next? Ultrasound imaging of superficial soft-tissue palpable lesions

Soft-tissue palpable lesions are common in clinical practice, and ultrasound (US) represents the first imaging option in the evaluation of a patient with a soft-tissue swelling. A full and systematic US assessment is necessary, however. This includes grayscale, color- and power-Doppler, spectral-Doppler, and possibly elastography facilities, as well as a trained operator. Several lesions showing characteristic US features can be diagnosed confidently, without any further work-up, and the high spatial resolution of ultrasound in the superficial layers can be a powerful tool to discriminate their etiologies. Second-level options, to be reserved for indeterminate cases or those suspected malignant at initial ultrasound, include magnetic resonance imaging, percutaneous fine-needle aspiration or biopsy, and surgical-excision biopsy. In this article, we discuss the proper US approach for addressing superficial soft-tissue lesions.