A case report of a 47 year-old man with finger swelling and progressive sensory loss is reported. The mass appeared without any history of trauma, and it was painless. Flexion was limited by the volume of the mass, and attempted full flexion produced paresthesias in the digit. Surgical excision was performed, revealing a charactheristic reddish partially-thrombosed mass, consistent with a vascular malformation. The nerve was noted to be externally compressed by the mass, and the patient's symptoms resolved following excision.
The authors state that this is the first report of digital nerve compression by a vascular malformation. However, they do note that many other similar benign processes have been reported to cause similar symptoms, including ganglion cysts, giant cell tumors, lipomas, and hemangiomas. In fact, the absence of a previous reported case may reflect simply a lack of reporting, as digital vascular malformations are relatively common lesions, and the methods by which compression occurs are analogous to other benign compressive tumors. Nonetheless, it serves as a reminder that careful digital neurologic exam is important in preoperative assessment and planning.
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