Solitary Myxoid Neurofibroma of the Palm.

Abstract

Dear sir A 21-year-old femalepresented with a four-month history of a gradually-enlarging mass of her non-dominant left palm. She denied pain at rest, but noted some discomfort when firm pressure was applied to the area. She also noted mild tingling in the middle and ring fingers. The patient had no history of trauma or prior surgery to the area. Past medical history was unremarkable. On physical exam there was a nodular mass palpable at the base of the middle and ring fingers at the level of the distal palmar crease, measuring approximately one x one centimeters (cm). Sensation to light touch and capillary refill were normal throughout. She had full wrist and digital range of motion. An MRI of the left hand demonstrated a homogenous cylindrical mass measuring 1.9 × 0.7 × 0.8 cm, that was hypo- and hyperintense on T1- and T2-weighted imaging, respectively. The patient underwent surgical excision under tourniquet control, with intravenous sedation and local anesthetic. The mass was seen tenting the common sensory nerve to the ring and middle fingers. The nerve was mobilized and neurolysed from the underlying mass, which was subsequently excised from the surrounding soft tissues. After hemostasis of feeder vessels was achieved, the skin was closed. Gross examination of the specimen revealed a pale yellow well-demarcated, elongated mass measuring 2.0 × 0.7 × 0.7 cm. (Fig. 1).