Soft tissue tumors in the hand have a broad differential diagnosis. Included in the list of differential diagnoses for these tumors are Schwannomas, which are benign tumors within the peripheral nervous system [1]. Schwannomas are uncommon within the upper extremity, and they are exceedingly rare within the hand and wrist [1]. We describe a case of an 80-year-old female presented with a soft tissue mass within her right thumb. She underwent excisional biopsy of the mass, and pathology showed features consistent with schwannoma. She had resolution of her symptoms thereafter. We discuss the differential diagnosis for soft-tissue tumors in this location. When assessing patients with soft tissue tumors of the hand and wrist, it is important for the treating provider to maintain a broad differential diagnosis in order to facilitate appropriate management of these lesions.
References
[1]
Dwyer, C.L., Creager, A.J. and Lubahn, J.D. (2014) An Unusual Presentation of a Digital Schwannoma: Case Report. Hand, 10, 301-304. https://doi.org/10.1007/s11552-013-9590-x
[2]
Martinez, R., Oladimeji, A.E. and Wilson, R.H. (2023) A Rare Presentation of Plexiform Schwannoma of the Thumb. JournalofHandSurgeryGlobalOnline, 5, 371-374. https://doi.org/10.1016/j.jhsg.2023.01.005
[3]
Martuza, R.L. and Eldridge, R. (1988) Neurofibromatosis 2. NewEnglandJournalofMedicine, 318, 684-688. https://doi.org/10.1056/nejm198803173181106
[4]
Adani, R., Baccarani, A., Guidi, E. and Tarallo, L. (2008) Schwannomas of the Upper Extremity: Diagnosis and Treatment. La Chirurgia degli Organi di Movimento, 92, 85-88. https://doi.org/10.1007/s12306-008-0049-0
[5]
Vlychou, M. and Dailiana, Z.H. (2011) Ancient Schwannoma of the Hand. TheJournalofHandSurgery, 36, 2030-2033. https://doi.org/10.1016/j.jhsa.2011.08.009
[6]
Refalo, A. and Mallina, R. (2022) Benign Schwannoma of the Thumb; a Diagnostic Challenge. RadiologyCaseReports, 17, 477-480. https://doi.org/10.1016/j.radcr.2021.11.019
[7]
Lee, S.J. and Yoon, S.T. (2017) Ultrasonographic and Clinical Characteristics of Schwannoma of the Hand. ClinicsinOrthopedicSurgery, 9, 91-95. https://doi.org/10.4055/cios.2017.9.1.91
[8]
Joshi, R. (2012) Learning from Eponyms: Jose Verocay and Verocay Bodies, Antoni a and B Areas, Nils Antoni and Schwannomas. IndianDermatologyOnlineJournal, 3, 215-219. https://doi.org/10.4103/2229-5178.101826
[9]
Nepal, P., Songmen, S., Alam, S.I., Gandhi, D., Ghimire, N. and Ojili, V. (2019) Common Soft Tissue Tumors Involving the Hand with Histopathological Correlation. JournalofClinicalImagingScience, 9, Article No. 15. https://doi.org/10.25259/jcis-6-2019
[10]
Strike, S.A. and Puhaindran, M.E. (2020) Tumors of the Hand and the Wrist. JBJSReviews, 8, e0141. https://doi.org/10.2106/jbjs.rvw.19.00141
[11]
Hsu, C.S., Hentz, V.R. and Yao, J. (2007) Tumours of the Hand. The Lancet Oncology, 8, 157-166. https://doi.org/10.1016/s1470-2045(07)70035-9
[12]
Marteau, É., Le Nail, L., Rosset, P., de Pinieux, G., Laulan, J., Roulet, S., et al. (2020) Epidemiological, Clinical and Histological Features of Adipose Tumors in the Hand and Wrist: Findings from a Continuous Series of 37 Cases. Orthopaedics&Traumatology: Surgery&Research, 106, 329-334. https://doi.org/10.1016/j.otsr.2019.12.011
[13]
MacGillis, K.J., Heaberlin, J. and Mejia, A. (2018) Clinical Decision Making for a Soft Tissue Hand Mass: When and How to Biopsy. TheJournalofHandSurgery, 43, 1123-1129. https://doi.org/10.1016/j.jhsa.2018.03.032
[14]
El Sayed, L., H Masmejean, E., Lavollé, A., Biau, D. and Peyre, M. (2022) Clinical Results after Surgical Resection of Benign Solitary Schwannomas: A Review of 150 Cases. Orthopaedics&Traumatology: Surgery&Research, 108, Article ID: 103281. https://doi.org/10.1016/j.otsr.2022.103281
[15]
Raj, C., Chantelot, C. and Saab, M. (2020) Predictive Factors of Postoperative Deficit and Functional Outcome after Surgery for Upper Limb Schwannomas: Retrospective Study of 21 Patients. HandSurgeryandRehabilitation, 39, 229-234. https://doi.org/10.1016/j.hansur.2020.02.001