Entrapment Neuropathy of Median and Ulnar Nerve Due to Soft Tissue Chondroma: A Case Report

연부조직 연골종에 의한 정중, 척골포착신경병증: 증례보고

  • Hong, Sung-Taek (Department of Plastic Surgery, Korea University College of Medicine) ;
  • Ahn, Duck-Sun (Department of Plastic Surgery, Korea University College of Medicine)
  • 홍성택 (고려대학교 의과대학 성형외과학교실) ;
  • 안덕선 (고려대학교 의과대학 성형외과학교실)
  • Received : 2010.02.25
  • Accepted : 2010.04.16
  • Published : 2010.11.10

Abstract

Purpose: Soft tissue chondroma is a rare benign tumor, found mainly on the palm and sole and grows slowly. Typically, mature hyaline cartilage is the dominant pathological feature. There are reports that assert soft tissue chondromas to be a cause of median nerve entrapment syndrome. However, this is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy. Methods: A 62 year-old woman presented with chief complaints of numbness and hypoesthesia of her right palm for 4 to 5 years, and a palpable mass on her right palm that had been increasing in size slowly for 3 years. Physical examination revealed a firm, mobile, non-tender and about $3{\times}3\;cm^2$ sized mass in the center of the right palm. Electromyography showed entrapment neuropathy of the median and ulnar nerve. Ultrasonography showed an approximately $5.7\;cm^2$ mass below the flexor tendon of ring finger. Upon surgical excision, a $3{\times}3\;cm^2$ mass attached to the flexor digitorum profundus of ring finger and redness and hypertrophy of both the median and ulnar nerve were discovered. Mass excision was performed gently and the specimen was referred for histopathologic study. Mass excision resulted in median and ulnar nerve release. Results: The pathology report confirmed the mass to be a soft tissue chondroma with mature hyaline cartilage. The patient exhibited post-operative improvement of her symptoms and did not show any complications. Conclusion: This is the first case report showing soft tissue chondroma to be a cause of simultaneous median and ulnar neuropathy.

Keywords

References

  1. Chung EB, Enzinger FM: Chondroma of soft parts. Cancer 41: 1414, 1978 https://doi.org/10.1002/1097-0142(197804)41:4<1414::AID-CNCR2820410429>3.0.CO;2-O
  2. Cumming D, Massraf A, Jones JW: Extraskeletal chondroma as cause of carpal tunnel syndrome: a case report. Hand Surg 10: 327, 2005 https://doi.org/10.1142/S0218810405002954
  3. Avci G, Aydogdu E, Yidirim S, Akoz T: Soft-tissue chondroma in the thumb. Plast Reconstr Surg 110: 1599, 2002 https://doi.org/10.1097/00006534-200211000-00041
  4. Dellon AL: Nerve entrapment syndromes. In Methes SJ, Henz VR (eds): Plastic Surgery. 2nd ed, Philadelphia, Saunders., 2006, p 875
  5. Bansal M, Goldman AB, DiCarlo EF, McCormack R: Soft tissue chondromas: diagnosis and differential diagnosis. Skeletal Radio 22: 309, 1993