Leiomyoma of the hand: A case report and review of the literature

Abstract

An 18-year-old, right-handed black woman presented with a 1-year history of a mass at the base of her right fourth finger. Physical examination revealed a painless 1 • 1 cm soft, mobile mass at the palmar aspect of the fourth metacarpophalangeal joint (Fig. 1) unassociated with sensory or motor compromise. An x-ray film of the right hand showed a soft tissue mass with two microcalcifications, most compatible with a hemangioma. Excision of the tumor was performed under general anesthesia. At surgery, the tumor dissected easily from surrounding structures and was not adherent to tendons, vessels or deep tissue layers (Fig. 2). Microscopic examination revealed a nodule composed of interlacing bundles of smooth nonstriated muscle (Fig. 3). Throughout the lesion were scattered thin-walled vessels that were on occasion associated with small areas of calcification. The nuclei were bland and rounded to slightly fusiform (Fig. 4). Myofibrils were identified by electron microscopy. The surgical wound was closed with a split-thickness skin graft (Fig. 5). At the patient's most recent postoperative visit the incision had healed, motor and sensory function were intact, and there was full range of motion.