DOI QR코드

DOI QR Code

A Fibroma of Tendon Sheath Causing Carpal Tunnel Syndrome: A Case Report of an Atypical Clinical Presentation

건수초섬유종에 의해 유발된 손목터널증후군: 비전형적인 임상 소견에 대한 증례 보고

  • Ara Ko (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Geun Young Lee (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Sujin Kim (Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Jaesung Lee (Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine) ;
  • Hye Won Hwang (Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine)
  • 고아라 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 이근영 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 김수진 (중앙대학교 의과대학 중앙대학교병원 영상의학과) ;
  • 이재성 (중앙대학교 의과대학 중앙대학교병원 정형외과) ;
  • 황혜원 (중앙대학교 의과대학 중앙대학교병원 병리과)
  • Received : 2020.08.17
  • Accepted : 2021.04.17
  • Published : 2021.11.01

Abstract

Fibroma of the tendon sheath is a benign slow-growing fibrous tumor. Although rare, cases occurring in the upper extremities usually involve the fingers. It appears as a well-defined, roundor oval-shaped mass originating from the flexor tendon. Abundant fibrous stroma makes fibromas appear as a low intensity mass in all MRI sequences. Most of the fibromas manifest as painless soft tissue masses. Herein, we report a case of fibroma of the tendon sheath with an unusual clinical presentation, triggering carpal tunnel syndrome during wrist movement.

힘줄의 섬유종은 천천히 자라는 양성 종양이다. 드물지만, 상지에 생길 수 있고 특히 손가락 굽힘 힘줄에 잘 생긴다. 섬유종은 대부분 경계가 좋은 원형 혹은 타원형의 종괴로 보이며, 풍부한 섬유조직에 의해 자기공명영상의 모든 영상에서 어둡게 보이는 것이 특징이다. 대부분의 섬유종은 무증상의 종괴로서 나타나지만, 드물게 증상을 야기하기도 한다. 우리는 손목의 반복적인 움직임에 의해 손목터널증후군을 유발하는 힘줄의 섬유종과, 그와 관련된 영상 소견에 대해 보고하고자 한다.

Keywords

References

  1. Al-Qattan MM. Fibroma of tendon sheath of the hand: a series of 20 patients with 23 tumours. J Hand Surg Eur Vol 2014;39:300-305 https://doi.org/10.1177/1753193412469146
  2. Dinauer PA, Brixey CJ, Moncur JT, Fanburg-Smith JC, Murphey MD. Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics 2007;27:173-187 https://doi.org/10.1148/rg.271065065
  3. Horcajadas AB, Lafuente JL, de la Cruz Burgos R, Muniz SH, Roca SA, Ortega SG, et al. Ultrasound and MR findings in tumor and tumor-like lesions of the fingers. Eur Radiol 2003;13:672-685 https://doi.org/10.1007/s00330-002-1477-0
  4. Lee CH, Tandon A. Focal hand lesions: review and radiological approach. Insights Imaging 2014;5:301-319 https://doi.org/10.1007/s13244-014-0334-4
  5. Kransdorf MJ. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol 1995;164:395-402 https://doi.org/10.2214/ajr.164.2.7839977
  6. Kransdorf MJ, Murphey MD. Imaging of soft tissue tumors. 3rd ed. Philadelphia: Wolters Kluwer Health Adis (ESP) 2013:231-360
  7. Chung J, Namkoong S, Sim JH, Lee JS, Hong SP, Kim MH, et al. Deep penetrating benign fibrous histiocytoma of the foot associated with throbbing pain. Ann Dermatol 2011;23:S239-S242 https://doi.org/10.5021/ad.2011.23.S2.S239
  8. Ge Y, Guo G, You Y, Li Y, Xuan Y, Jin ZW, et al. Magnetic resonance imaging features of fibromas and giant cell tumors of the tendon sheath: differential diagnosis. Eur Radiol 2019;29:3441-3449 https://doi.org/10.1007/s00330-019-06226-4
  9. Musso M, Schilton I, Pallotti F. Tendinous sheath fibroma causing "trigger wrist" and carpal tunnel syndrome. Chir Main 2006;25:89-91 https://doi.org/10.1016/j.main.2006.03.001
  10. Benhima MA, Ait Essi F, Abkari I, Najeb Y, Fikry T. Carpal tunnel syndrome and "trigger wrist" revealing a tendinous sheath fibroma. Chir Main 2013;33:59-62 https://doi.org/10.1016/j.main.2013.11.006