Arch Hand Microsurg.  2017 Dec;22(4):268-272. 10.12790/ahm.2017.22.4.268.

Subungual Schwannoma Mimicking Glomus Tumor on Ultrasonography: A Case Report

• Lee CH
• Baek JH
• Kim KJ
• Lee HH
• Chung DW
• Lee JH

• KMID: 2406131
• DOI: http://doi.org/10.12790/ahm.2017.22.4.268

Abstract

A 29-year-old male patient complained subungual palpable mass with sharp pain. Ultrasonography showed a lobulated, hypoechoic, vascularized mass that was distinct from the surrounding soft tissue of 1.2×0.9×0.6 cm in size, probably a glomus tumor. Authors performed surgical excision and excisional biopsy, and pathological study was diagnosed schwannoma. Subungual schwannoma is very rare and have been reported as a painless mass. Authors report a case of painful subungual schwannoma mimicking glomus tumor on ultrasonography.

Keyword

Schwannoma; Fingers; Subungual

MeSH Terms

Adult
Biopsy
Fingers
Glomus Tumor*
Humans
Male
Neurilemmoma*
Ultrasonography*

Figure

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  Fig. 1 Preoperative photographs views of the lesion (circle).

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  Fig. 2 Transverse (A) and longitudinal (B) ultrasonography images show 1.2×0.9×0.6-cm-sized well-defined, lobulated, round, and hypoechoic cystic mass at the radial side under the nail plate. (C, D) Color Doppler ultrasonography shows subtle flow signals around the hypoechoic area.

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  Fig. 3 well encapsulated and single-lobulated, yellowish-white colored mass. The ovoid mass was 1.2×1.0×0.5-cm-sized.

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  Fig. 4 Histopathologic finding of the lesion, showing the typical palisaded spindle cell pattern of a Schwannoma. Antoni A (large arrow) and B (small arrow) patterns were showed (H&E, ×200).

Reference

1. Holdsworth BJ. Nerve tumours in the upper limb. A clinical review. J Hand Surg Br. 1985; 10:236–238.

2. Rockwell GM, Thoma A, Salama S. Schwannoma of the hand and wrist. Plast Reconstr Surg. 2003; 111:1227–1232.

3. Phalen GS. Neurilemmomas of the forearm and hand. Clin Orthop Relat Res. 1976; (114):219–222.

4. Huntley JS, Davie RM, Hooper G. A subungual schwannoma. Plast Reconstr Surg. 2006; 117:712–713.

5. Moon SE, Cho YJ, Kwon OS. Subungual schwannoma: a rare location. Dermatol Surg. 2005; 31:592–594.

6. Kulkarni J, Moholkar A, Patil A. Subungual schwannoma: an uncommon location. J Hand Surg Am. 2013; 38:1258–1259.

7. Soto R, Aldunce MJ, Wortsman X, Sazunic I. Subungual schwannoma with clinical, sonographic, and histologic correlation. J Am Podiatr Med Assoc. 2014; 104:302–304.

8. Han KJ, Lee YS, Park M. Digital nerve schwannoma of the hand. J Hand Surg Eur Vol. 2012; 37:361–362.