Ganglion of the Flexor Tendon Sheath at the A2 Pulley - Case Report

Abstract

There are few reported cases of flexor tendon sheath ganglion arising from the A2 pulley. We report a case of a flexor tendon sheath ganglion in a 17-year old female who presented with pain, triggering and a swelling at the base of her right ring finger. During the excision biopsy, a ganglion measuring 0.5×0.8×0.4 cm in size was removed from the A2 pulley area.

Flexor Tendon Sheath Ganglion of the A1 Pulley Causing Trigger Thumb: A Case Report

“…There are several hypotheses regarding the formation of these cysts including myxoid degeneration, increased production of hyaluronic acid and nonspecific proliferation of mesenchymal cells [7]. Doyle proposed possibility of tear in the synovial membrane and subsequent healing with an extracapsular segment of synovium that secretes synovial fluid [5]. Nelson et al proposed a post traumatic etiology [8][9].…”

“…Critical review of literature suggest that ganglion cysts flexor synovial sheath is uncommon cause of triggering. Ganglion cysts around the hand and wrist comprise about 60% of all hand tumors of which 5-16% occur along the flexor tendon sheaths [5][6]. Ganglion cyst of A1 pulley resulting in triggering of thumb is highly uncommon and this is only the second reported case in English literature.…”