Pacinian Corpuscles Neuroma. An Exceptional Cause of Pain in the Hand

Abstract

Pacinian corpuscles are rapidly adapting mechanoreceptors mainly distributed in the dermis of the fingers and palm of the hand. A neuroma of the Pacinian corpuscle is a rare and extremely painful condition with a few cases reported in the literature, most of them, associated with local or repetitive trauma. We present a 71-year-old man with history of pain and swelling on his left index without history of previous trauma initially diagnosed as tenosynovitis resistant to conservative treatment in which we observed, directly in the subcutaneous plane, spherical, gray and in clusters lesions closer to the collateral nerve which were described by the pathological study as neuroma of the Pacinian corpuscles.

Bilateral Nonsynchronous Pacinian Corpuscle Neuroma

“…13 The definitive diagnosis of pacinian neuroma is usually made in the operating room when identifying these clustered lesions and after the pathological study of the excised tissue. Complete surgical excision seems to be curative as occurred in all published cases (when outcome was reported) 5,7,10 and in both instances in our report. We believe that pacinian corpuscle neuroma should be considered in the differential diagnosis of localized painful swelling in hand of unknown etiology, particularly, but not only, in patients with previous trauma.…”

“…4 We have recently reported the case of a 71-yearold man with a pacinian corpuscle neuroma on his left index finger. 5 Two years later, he developed a new pacinian corpuscle neuroma on his right index finger. To the best of our knowledge, this is the first reported case with a bilateral nonsynchronous pacinian corpuscles neuroma of the hand.…”

Multiple intraneural glomus tumors in different digital nerve fascicles

“…Because of the presence of numbness and a positive Tinel’s sign, the present case was initially diagnosed as a neuroma. Pacinian corpuscles neuroma was pain and swelling tumor in finger with or without history of trauma, subcutaneous plane, spherical, gray and in clusters lesions can be observed in pathological study [13]. Giant cell tumor of tendon sheath is a common benign with incentives, multiple nodules tumor arising in the tendon sheath.…”

Pacinian neuromas and neurofibromas of the hands and fingers: a systematic review

“…The terms ‘Pacinian neuroma’, ‘Pacinian hypertrophy’, and ‘Pacinian hyperplasia’ have been used interchangeably in the past and in some recent articles, regardless of the presence or absence of trauma, which is misleading (Cho et al., 2012; Jiménez et al., 2017; Kenmochi et al., 2006; Lang-Stevenson, 1984; Mahipathy et al., 2015; Narayanamurthy et al., 2005; Patterson, 1956; Rhode and Jennings, 1975; Schuler and Adamson, 1978; Zanardi et al., 2011). Other authors have also noted this inconsistent and occasionally confusing terminology (Jiménez et al., 2017; Kuhn et al., 1988). To avoid misdiagnosis and mislabelling in the future, the pathological processes involving Pacinian corpuscles should be labelled either as Pacinian corpuscle hyperplasia (or neuroma, if a traumatic aetiology is involved) or as PCNF, according to the specific histological findings.…”