Farzan Jessica J, Johal Ovninder, Cervantes Thomas, Rothkopf Douglas M
From the Division of Plastic Surgery, UMass Chan Medical School, Worcester, MA.
Plast Reconstr Surg Glob Open. 2025 Jul 1;13(7):e6931. doi: 10.1097/GOX.0000000000006931. eCollection 2025 Jul.
Pseudoaneurysms of the digital arteries are rare, with fewer than 20 cases reported. They typically result from partial vessel wall injuries due to trauma, repetitive microtrauma, or iatrogenic causes. Their rarity is attributed to the small diameter of the digital arteries, which makes complete laceration or thrombosis more likely than partial injury. We present the case of a 43-year-old man who developed a thumb radial digital artery pseudoaneurysm after workplace trauma. Initially misdiagnosed, the patient underwent unsuccessful bedside drainage at an urgent care center. Clinical examination revealed a 2 × 2 cm mass on the volar, radial aspect of the proximal thumb phalanx. Doppler ultrasonography confirmed the diagnosis of a pseudoaneurysm. Surgical intervention, performed 10 months postinjury, revealed a 15-mm mass continuous with the radial digital artery. The pseudoaneurysm was successfully resected via artery ligation. Microscopic examination revealed mixed features of both pseudoaneurysm and pyogenic granuloma, presenting an even rarer clinical entity. To our knowledge, this is the first report of a mixed pseudoaneurysm and pyogenic granuloma located in the radial digital artery of the thumb. This case underscored the importance of considering complex vascular anomalies in persistent digital masses posttrauma and emphasized the value of comprehensive histological examination for accurate diagnosis.
指动脉假性动脉瘤较为罕见，报道的病例不足20例。它们通常由创伤、重复性微创伤或医源性原因导致的部分血管壁损伤引起。其罕见性归因于指动脉直径较小，这使得完全撕裂或血栓形成比部分损伤更有可能发生。我们报告一例43岁男性病例，该患者在工作场所受伤后发生拇指桡侧指动脉假性动脉瘤。最初被误诊，患者在紧急护理中心进行的床边引流未成功。临床检查发现近端拇指指骨掌侧桡侧有一个2×2 cm的肿块。多普勒超声检查确诊为假性动脉瘤。受伤10个月后进行手术干预，发现一个15 mm的肿块与桡侧指动脉相连。通过动脉结扎成功切除假性动脉瘤。显微镜检查显示假性动脉瘤和化脓性肉芽肿的混合特征，呈现出一种更为罕见的临床实体。据我们所知，这是首例位于拇指桡侧指动脉的混合性假性动脉瘤和化脓性肉芽肿的报告。该病例强调了在创伤后持续性手指肿块中考虑复杂血管异常的重要性，并强调了全面组织学检查对准确诊断的价值。
