PMC8112364_01
Swelling on the thenar aspect of the right palm
NJS-27-75-g001.jpg
PMC8112364_01_NJS-27-75-g001.jpg
F1
A 42-year-old male farmer from the rural outskirts of Ranchi, Jharkhand, presented to the general surgery outpatient department of our hospital with the complaint of a painless swelling in the right palm for the past 2 years [Figure 1].
Magnetic resonance imaging (T2-weighted) showing a well-defined, sharply demarcated, heterogeneously hyperintense lesion
NJS-27-75-g002.jpg
PMC8112364_01_NJS-27-75-g002.jpg
F2
Magnetic resonance imaging (MRI) of the hand and wrist revealed a well-defined, sharply demarcated, heterogeneously hyperintense lesion of size 6 cm x 3 cm on proton density and T2-weighted images and hypointense on T1-weighted seen along the thenar eminence of the right hand with widening of space between the first and second metacarpals suggestive of a space-occupying lesion (SOL) in the hand with a benign pathology [Figure 2].
(a) Intraoperative view of the lesion while dissection. (b) Specimen after complete excision
NJS-27-75-g003.jpg
PMC8112364_01_NJS-27-75-g003.jpg
F3
After careful dissection and identification of the digital nerve and vessels, an 8.0 cm x 2.5 cm x 2.5 cm lobulated mass was seen to be arising from a digital nerve in the thenar eminence, which was excised in toto via blunt dissection [Figure 3a and b].
Image of the right hand after 3 weeks of surgical excision of the space-occupying lesion
NJS-27-75-g004.jpg
PMC8112364_01_NJS-27-75-g004.jpg
F4
The wound was healed properly, and there was no complaint of paresthesia or any evidence of recurrence [Figure 4].