A haemangioma of the flexor tendon sheath causing carpal tunnel syndrome

Kim, Ji Yeong; Sung, Jung Hwan; Lee, S.

doi:10.1177/1753193409347688

Cited by 6 publications

(5 citation statements)

References 4 publications

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“…Complete excision can resolve the symptoms in patients with a hemangioma. In some cases, excision under loupe magnification is required and surrounding tissue must be excised as well to prevent recurrence 22 …”

Section: Discussionmentioning

confidence: 99%

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Anatomic Variations and Malformations as Rare Causes of Median Nerve Compression in Adults

et al. 2021

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Objective: The median nerve can become compressed at multiple points in the arm, causing carpal tunnel-, pronator-, anterior interosseous-, or lacertus syndrome. Anatomical variations are potential reasons of persisting or recurrent symptoms of median nerve compression and are often recognized late. The objective of this study is to provide a comprehensive list of rare anatomical variations and malformations causing median nerve compression. Methods: A total of 62 studies describing median nerve compression due to an anatomical structure in adults published from 2000 in English were included. The findings were: 35 tenomuscular, 16 vascular causes, and 4 cases with nerve involvement. Only 1 osseous and 18 combined anomalies caused compression. In 18 cases, the anomaly was found in the proximal forearm. Results: In 44 cases, the median nerve was surgical released and 35 anomalies were completely resected. Persistent or recurrent symptoms were present in 13 cases. During follow-up, 1 case of recurrence was reported.Standard operative option for median nerve compression consists of an open median nerve release. Conclusions: In case of persistent or recurrent carpal tunnel syndrome, unilateral symptoms, the presence of a palpable mass, manifestation of symptoms at young age and pain in the forearm or upper arm, the surgeon has to rule out the presence of an anatomical anomaly. Complete resection of the anomaly is not always necessary. The surgeon should be aware of potential anomalies to avoid inadvertent damage at surgery.

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Section: Discussionmentioning

confidence: 99%

“…In some cases, excision under loupe magnification is required and surrounding tissue must be excised as well to prevent recurrence. 22…”

Section: Vascularmentioning

confidence: 99%

Anatomic Variations and Malformations as Rare Causes of Median Nerve Compression in Adults

et al. 2021

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“…8 Kim et al have reported flexor tendon hemangioma presenting with symptoms of carpal tunnel syndrome in which symptoms were exacerbated after a minor trauma. Trauma as etiology of hemangioma has not been conclusively proven [9][10][11] (►Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…14 Preoperative diagnosis with imaging is not always conclusive. 5,10 Conclusive evidence is obtained after histopathology study.…”

Section: Discussionmentioning

confidence: 99%

Tendon Sheath Hemangioma

Dalei

Loya

2019

Journal of Hand and Microsurgery

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“…Synovial angiomas arising from the upper extremity tendon sheaths are exceedingly rare [11-13]. To date, only one case of synovial angioma arising from a tendon sheath within the carpal tunnel has been reported [14]. …”

Section: Discussionmentioning

confidence: 99%

Synovial Angioma of the FDP Flexor Sheath: A Rare Cause of Carpal Tunnel Syndrome

George

Lee²

2013

TOORTHJ

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It has been previously noted that synovial haemangiomas in the hand and wrist are very rare pathological entities. We report the case of a 34-year-old right hand dominant male who presented to his general practitioner with an enlarging left volar wrist/ palmar mass, who further developed symptoms consistent with carpal tunnel syndrome. An MRI scan subsequently confirmed a large, complex mass with area of necrosis and peripheral enhancement. The rate of mass growth and radiological features raised the possibility of a soft tissue malignancy, and the gentleman was urgently referred to our unit for surgical exploration and removal of tumour. Surgical exploration demonstrated a tan-coloured soft tissue mass on the ulnar aspect of the median nerve. It appeared to arise from, and marginally infiltrated, the tendon sheath of the FDP tendon to the ring finger and the lumbrical muscle of the fourth ray; the distal and proximal extent of the tumour was difficult to define due to the diffuse growth of the tumour. Resection was achieved with macroscopic margins, with excellent functional recovery immediately and at 6 month follow-up. Histological analysis was consistent with a synovial haemangioma, comprising of numerous thin-walled blood vessels with a central cystic cavity containing blood and fibrin. Our case further demonstrates the diagnostic challenges posed by compressive neuropathy due to soft tissue masses, even with thorough clinical and radiological assessment. In the context of a rapidly growing tumour, malignancy must always be suspected and might highlight a role for pre-operative biopsy.

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A haemangioma of the flexor tendon sheath causing carpal tunnel syndrome

Cited by 6 publications

References 4 publications

Anatomic Variations and Malformations as Rare Causes of Median Nerve Compression in Adults

Anatomic Variations and Malformations as Rare Causes of Median Nerve Compression in Adults

Tendon Sheath Hemangioma

Synovial Angioma of the FDP Flexor Sheath: A Rare Cause of Carpal Tunnel Syndrome

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