Schwannoma - hand

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Right index finger MCP joint volar side nodule - few years. Mild local pain.

Patient Data

Age: 50 years
Gender: Female
ultrasound

A well-defined lesion (about 15 x 10 x 8 mm) on the volar side of the index finger MCP joint lying superficial to the flexor tendons. Normal echopattern of the underlying flexor tendon without tenosynovitis. The tendon movement was free from the lesion. The non-compressible lesion shows a peripheral echogenic rim with central heterogeneous hypoechogenicity without cystic spaces/ calcification/ vascularity. Acoustic enhancement is present. The digital neurovascular bundle was elevated by the lesion.

Photo

The surgery revealed a solid lesion separate from the flexor tendon.

Case Discussion

The case shows a volar side lesion at the MCP joint of the index finger. Surgical excision was done. Histopathology revealed schwannoma.

Intraoperative photos courtesy: operating surgeon Dr. Pinkesh Patel.

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