The Intraneural Hemangioma of the Digital Nerve: Case Report

Abstract

Intraneural Hemangioma of the digital nerve is rare and so far three cases have been reported in the literature. We present a case of 12-year-old boy with painless soft tissue mass in the right hand and numbness on the radial aspect of the index finger. Magnetic Resonance Imaging showed an isointense subcutaneous lesion without discrete borders in the first web space classically of hemangioma with the radial digital nerve extension. On exploration, the intraneural extension of the hemangioma was confirmed and total resection, microsurgical primary digital nerve repair was done. The patient became better and at 6 months follow up the index finger sensation improved. The patient had no reccurence and he is still under follow up.

Ultrasonographic and Imaging Appearance of Peripheral Intraneural Vascular Anomalies: Report of Two Cases and Review of the Literature.

“…According to our review, the current imaging techniques commonly used, US (high resolution gray scale US, Doppler) and MRI, demonstrated a close relation between the nerve path and the vascular anomaly, accurately indicating the diagnosis in 22 cases [23,[26][27][28][29][30][31][32][33][34][35]37]. Also, we found a single case in which postoperative histopathological examination confirmed the imaging diagnosis of hemangioma, established exclusively by using computed tomography [13].…”

“…Pathology For 30 cases (55.55%) the final diagnosis was hemangioma, based on histopathological analysis. Of these tumors, 24 were located at the level of upper limb, affecting the median nerve (11 cases) [3,9,13,15,18,[23][24][25]30,32], ulnar nerve (8 cases) [8,16,19,26,31,33], digital branches of ulnar and radial nerves (4 cases) [7,20,29,31] and the inferior trunk of brachial plexus (1 case) [22]. The other 6 tumors were located at the level of lower limb, involving the sciatic nerve (2 cases) [27,31], peroneal nerve (3 cases) [5,11,19] and posterior tibial nerve (1 case) [14].…”

“…The other 6 tumors were located at the level of lower limb, involving the sciatic nerve (2 cases) [27,31], peroneal nerve (3 cases) [5,11,19] and posterior tibial nerve (1 case) [14]. These lesions were named differently by the authors: hemangioma [3,11,13,16,[18][19][20]22,24,26,31,33], intraneural hemangiomas [5,[7][8][9]15,23,29], endoneural hemangioma, intrinsic hemangioma [25] or capillary hemangioma [27,30,32]. Konet al [7] described one case in which the coexistence of an intraneural hemangioma and an extraneural cavernous hemangioma at the level of the digital branches of the ulnar nerve was observed.…”

“…Hemangiomas (17 cases) appear as tissue masses with hypo-or isosignal on T1 weighted sequences and T2 hypersignal, well delineated, with signal void due to multiple vessels, presenting early and heterogeneous enhancement after gadolinium [20,[22][23][24][25]27,29,[30][31][32][33].…”

Intraneural Hemangioma: Case Report of a Rare Tibial Nerve Lesion

“…An intraneural hemangioma is a rare, benign mesodermal lesion [1-4]. The first case was reported by Sommer in 1922 [5].…”