Localized acral hypertrophy.

Abstract

A 35-year-old male presented with complaints of a progressive increase in the size of his right thumb. There was a significant increase in subcutaneous tissue, which was most prominent on the palmar aspect. He was experiencing difficulty in his day-to-day work due to restricted movement. There was no history of trauma, infection, or a family history suggestive of neurofibromatosis or any similar disease. He had undergone surgery two years prior for similar complaints in the index finger. Plain radiograph of the hand [Figure 1] was advised following this magnetic resonance imaging (MRI) of the right hand was performed to confirm the diagnosis and assess the disease status [Figure 2]. Figure 1 (a) Clinical photograph showing localized enlargement of thumb with postoperative changes in index finger. (b) X-ray imaging of the hand shows hypertrophy of soft tissue and bone with mushroom shaped terminal phalanx. Secondary degenerative changes are ... Figure 2 Magnetic resonance imaging of the fingers. (a) T1-weighted imaging shows proliferation of the fibro-fatty tissue of the thumb. (b and d) Proton Density fat saturated image confirms the fatty nature. (c) T2-weighted imaging shows osteophyte formation with ... A plain X-ray of the hand of another patient with similar complaints in the middle finger showed increased lengths of metacarpals and phalanges of the middle finger with prominent soft tissue and is shown in Figure 3. Figure 3 X-ray imaging of the hand of another patient shows hypertrophy of soft tissue and bone of middle finger with advanced degenerative changes in the involved digits.