Division of Plastic Surgery, University of Pennsylvania, Philadelphia, PA, USA.
J Hand Surg Asian Pac Vol. 2020 Dec;25(4):508-512. doi: 10.1142/S2424835520720182.
We present a case of a 26-year-old right hand dominant male landscaper with a slow growing right ring finger subungual mass. MRI confirmed a 0.9 × 1.5 × 0.9 cm well circumscribed subungual mass believed to be consistent with a glomus tumor, although size and symptoms were not consistent with that diagnosis. The mass was completely excised and diagnosis of schwannoma was confirmed by H&E histology. A literature search was performed utilizing the term "subungual schwannoma." Four case reports were found describing this diagnosis in the hand as well as a single case report describing it in the foot. In summary, this is a 26-year-old male who presents with a schwannoma in the unusual subungual location. Although rare, based on our case and the existing literature, subungual schwannomas should be included in the differential diagnosis of a slow growing subungual mass, particularly if symptoms and exam are inconsistent with more common etiologies.
我们报告了一例 26 岁的右利手男性园林工人,其右无名指指甲下缓慢生长的肿块。MRI 证实为 0.9×1.5×0.9cm 的边界清楚的指甲下肿块,考虑为血管球瘤,尽管大小和症状与该诊断不一致。肿块被完全切除,H&E 组织学证实为神经鞘瘤。利用“指甲下神经鞘瘤”一词进行文献检索,发现了 4 例手部描述该诊断的病例报告,以及 1 例足部描述该诊断的病例报告。总之,这是一位 26 岁的男性,其指甲下出现了不常见的神经鞘瘤。尽管罕见,但根据我们的病例和现有文献,指甲下神经鞘瘤应包括在缓慢生长的指甲下肿块的鉴别诊断中,特别是如果症状和检查与更常见的病因不一致。