Chalidis Byron E, Dimitriou Christos G
1st Orthopaedic Department of Aristotle University of Thessaloniki, Greece.
World J Surg Oncol. 2007 Aug 8;5:92. doi: 10.1186/1477-7819-5-92.
Leiomyomas of the deep soft tissue are quite uncommon and occur even more rarely in upper extremity.
A 32-year old manual laborer man presented with a two-year history of numbness, tingling and burning pain in the palmar surface of the left hand and fingers. His medical history was unremarkable and no trauma episode was reported. According to the clinical examination and the result of median nerve conduction study (NCS) the diagnosis of carpal tunnel syndrome was established. Operative release of the transverse carpal ligament was subsequently performed but the patient experienced only temporary relief of his symptoms. MRI examination revealed a deep palmary located mass with well-defined margins and ovoid shape. Intraoperatively, the tumor was in continuity with the flexor digitorum superficialis tendon of the middle finger causing substantial compression to median nerve. Histopathological findings of the resected mass were consistent with leiomyoma. After two years the patient was pain-free without signs of tumor recurrence.
Despite the fact that reports on deep soft tissue leiomyoma are exceptional, this tumor had to be considered as differential diagnosis in painful non-traumatic hand syndromes especially in young patients.
深部软组织平滑肌瘤相当罕见，在上肢更为少见。
一名32岁男性体力劳动者，左手掌面及手指麻木、刺痛和灼痛两年。他的病史无异常，未报告有外伤史。根据临床检查和正中神经传导研究（NCS）结果，诊断为腕管综合征。随后进行了腕横韧带手术松解，但患者症状仅得到暂时缓解。MRI检查显示手掌深部有一肿块，边界清晰，呈椭圆形。术中发现肿瘤与中指指浅屈肌腱相连，对正中神经造成明显压迫。切除肿块的组织病理学检查结果与平滑肌瘤一致。两年后患者无痛，无肿瘤复发迹象。
尽管深部软组织平滑肌瘤的报道很少见，但在无痛性非创伤性手部综合征中，尤其是年轻患者，必须考虑将这种肿瘤作为鉴别诊断。
