Volar wrist ganglion associated with radial artery atherosclerosis: A case report.

RATIONALE

There have been no reports of volar wrist ganglions being associated with atherosclerosis of the radial artery. Good results were obtained with radial artery reconstruction through ganglion excision and autogenous vein grafting. Hence, we report a previously unreported case, along with a review of the literature.

PATIENT CONCERNS

A 58-year-old female presented with the chief complaint of a mass on the volo-radial side of her right wrist. The patient complained of a tingling sensation in the thumb, index, and extensor zones that worsened when pressing the mass.

DIAGNOSES

Sonography revealed a well-defined, anechoic cystic lesion adjacent to the radial artery.

INTERVENTIONS

Exploration was performed using a zig-zag incision on the mass. The superficial radial nerve (SRN), which innervates the thumb, was distorted by the mass and the nerve dissected from the mass. However, the artery and ganglion cysts were not separated completely in a part where hardening of the artery wall progressed as a result of degenerative changes, showing multiple small, hard, and yellowish masses. We resected the radial artery (approximately 1.5 cm) along with the ganglion and sent it for histological examination. The radial artery was then reconstructed using an autogenous venous graft.

OUTCOMES

At the 34-month follow-up, the patient was asymptomatic. Radial artery patency was normal without recurrence of the ganglion cyst.

LESSONS

In patients with risk factors for radial artery atherosclerosis, a more careful diagnosis is required for the surgical treatment of the volar wrist ganglion. In addition, if the ganglion and radial artery are not completely dissected, excision of the radial artery and subsequent reconstruction of the radial artery using an autogenous vein may be a good surgical strategy.