A rare cause of hand deformity: tenosynovial chondromatosis tumor of the wrist (a case report and review of the literature)

Paulius Dobrovolskis1, Mindaugas Minderis 2

1 Vilnius University Faculty of Medicine, Lithuania

2 Vilnius University Hospital Santaros Klinikos, Centre of Plastic and Reconstructive Surgery, Vilnius, Lithuania

Abstract

Background. Extra-articular tenosynovial chondromatosis is a rare, benign tumour arising from tendon sheath. We report a rare case of tenosynovial chondromatosis of the wrist and its unusual presentation as a deformity of the fingers that was successfully treated surgically.

Case report.75-year-old female patient presented with a pain, hard lump above the wrist and flexion deformity of the left hand. She complained of slightly numb fingers which she could not extend. There was a slight palmar numbness of the 5th finger. Mass with a hard and rough surface was observed above distal wrist crease, which was also visible on X-ray. There was a clinical suspicion that the mass was the cause for ulnar neuropathy and decision to perform an excision was made. During the surgery, tumour was found attached to the flexor tendons and was extending to the carpal tunnel on the ulnar side. After the excision of the tumour and release of carpal tunnel and Guyon’s canal, patient was able to extend her fingers more and with less pain. Pathohistological examination confirmed tenosynovial chondromatosis type tumour. Patient was re-examined 5 months after the surgery.

Conclusions. Tenosynovial chondromatosis is a rare, benign, slow growing tumour which most commonly occurs within hands and feet. Treatment of choice is surgical, although the risk for local recurrence is high. This case report might be the first to describe tenosynovial chondromatosis causing flexion deformity of the fingers and compressing the ulnar nerve at the hand.

 

Key words: tenosynovial chondromatosis, hand tumour, hand deformity.