case_images: PMC6766145_01
case_images: Clinical preoperative images of the patient's hand with volar-based mass spanning the second to fourth metacarpal heads.
case_images: CRIOR2019-3514013.001.jpg
case_images: PMC6766145_01_CRIOR2019-3514013.001.jpg
case_images: fig1
case_images: A 14-year-old right-hand-dominant Caucasian male presented with a history for several years of a slowly enlarging mass of the left palm centered about the third metacarpal head (Figure 1).
case_images: (a, b) Select preoperative T1 axial and T1 sagittal magnetic resonance images of FTS demonstrating relationship to flexor tendon and neurovascular bundle.
case_images: CRIOR2019-3514013.002.jpg
case_images: PMC6766145_01_CRIOR2019-3514013.002.jpg
case_images: fig2
case_images: Magnetic resonance imaging (MRI) with intravenous gadolinium demonstrated a 3.6 x 1.6 x 2.4 cm well-defined soft tissue mass centered about the third metacarpophalangeal joint abutting the flexor tendon sheath of the third digit (Figure 2).
case_images: Intraoperative image of well-encapsulated, solitary, solid tan-colored mass shown to be FTS.
case_images: CRIOR2019-3514013.003.jpg
case_images: PMC6766145_01_CRIOR2019-3514013.003.jpg
case_images: fig3
case_images: It was well-encapsulated without communication to any neurovascular or tendinous structure aside from the A1 pulley of the third flexor sheath (Figures 3 and 4).
case_images: Gross image of excised mass.
case_images: CRIOR2019-3514013.004.jpg
case_images: PMC6766145_01_CRIOR2019-3514013.004.jpg
case_images: fig4
case_images: It was well-encapsulated without communication to any neurovascular or tendinous structure aside from the A1 pulley of the third flexor sheath (Figures 3 and 4).
case_images: (a) Low-power examination demonstrates a mildly lobulated lesion with tumor cells set in a collagenous matrix. The lesion shows an admixture of hypocellular and hypercellular areas (hematoxylin and eosin stain, magnification 10x). (b) High-power examination demonstrates fibroblasts with basophilic nuclei in a focally hypercellular area. No mitotic figures are identified (hematoxylin and eosin stain, magnification 40x).
case_images: CRIOR2019-3514013.005.jpg
case_images: PMC6766145_01_CRIOR2019-3514013.005.jpg
case_images: fig5
case_images: Multinucleate giant cells were not seen (Figure 5).
case_images: (a, b) Clinical postoperative images of patient 21 months after surgery.
case_images: CRIOR2019-3514013.006.jpg
case_images: PMC6766145_01_CRIOR2019-3514013.006.jpg
case_images: fig6
case_images: He is currently at 21-month status postsurgical excision, reports pain-free activity, and exhibits no evidence of local recurrence (Figure 6).