Two Cases of Soft Tissue Tumor Causing Severe Pain in the Hand

Two cases of unusual hand tumor causing severe pain in the hand are presented in this study. [Case 1] A 24-year-old man was seen initially with a two month history of pain over the palmar aspect of his thumb. There was no history of trauma or an antecedent event related to the onset of symptoms. Neither neurological deficits nor tumor mass was observed. However, bumping the thumb produced severe pain. Surgical exploration of the thumb demonstrated a tumor fixed to the digital nerve. The mass measured 1 × 1.5mm, consisted of white tissue with well-defined margins and was excised under the operating microscope. Microscopic examination revealed segments of clusters of pacinian corpuscle, and the pathological diagnosis was pacinian neuroma. [Case 2] A 76-year-old woman noticed a eight month history of pain under the nail of her thumb finger. There was no antecedent trauma. She underwent surgical treatment for the tumor. Histology showed nerve bundle separated abundant fibro-fatty tissue. Pathological diagnosis was lipofibromatous hamartoma (neural lipofibroma).Postoperatively, the patients were both free from symptoms. Although Pacinian neuroma and lipofibromatous hamartoma are unusual source of digital pain, they should be kept in mind when approaching any hand tumor.