Trigger wrist is a relatively rare disease compared to trigger finger, which is the most common disorder found in hands. Patients with trigger wrist usually complain about the following symptoms: snapping and clicking or triggering around carpal tunnel with or without mild to moderate median neuropathy. There are a total of five cases of trigger wrist: three cases of anomalous muscle belly of flexor digitorum superficialis and two cases of fibroma around flexor tendon sheath within carpal tunnel. This study reports on two of those cases: one with anomalous muscle and the other with fibroma of flexor tendon sheath. Accurate examination and proper diagnosis are mandatory to obviate improper and time-wasting treatment for patients with trigger wrist.
Adult ; Female ; Fibroma ; Humans ; Male ; *Tenosynovitis/physiopathology/radiography/surgery ; *Wrist/physiopathology/radiography/surgery

Calcifying aponeurotic fibroma is a rare soft tissue tumor that occurs in the distal extremities of children and adolescents. We report ultrasound and X-ray findings of a calcifying aponeurotic fibroma in the finger of a 36-year-old woman, associated with distal phalangeal bone involvement.
Adult ; Bone Neoplasms/*radiography/surgery/*ultrasonography ; Calcinosis/*radiography/surgery/*ultrasonography ; Female ; Fibroma/*radiography/surgery/*ultrasonography ; *Fingers ; Humans ; Soft Tissue Neoplasms/*radiography/surgery/*ultrasonography ; Ultrasonography, Doppler, Color

Papillary fibroelastoma is a rare benign cardiac tumor that represents 10% of all primary cardiac tumors. Diagnosis is accomplished incidentally by echocardiography that is usually performed for another purpose. Most papillary fibroelastomas are asymptomatic, but the lesions are recognized as a cause of embolisms. To the best of our knowledge, there has been no case report of computed tomography findings of a papillary fibroelastoma. We report a case of a papillary fibroelastoma in a 78-yr-old woman who had dyspnea and chest tightness. Echocardiography revealed a small lobulated mobile echogenic mass attached to the aortic valve, and CT demonstrated a lobulated soft tissue density mass with a thin stalk at the sinotubular junction of the aortic valve.
Aged ; Aortography/*methods ; Female ; Fibroma/*radiography/*surgery ; Heart Neoplasms/*radiography/*surgery ; Humans ; Papillary Muscles/*radiography/*surgery ; Tomography, X-Ray Computed/*methods ; Treatment Outcome

BACKGROUNDNasopharygeal fibroangioma (NPF) can be approached through lateral rhinotomy, the middle skull fossa approach and the transcranial-facial combined approach. It is complicated and thus results in more insults, and when adopted, the total resection rate of tumor is still low. The nasal endoscope is minimally invasive, the dead angles of a craniotomy, such as sphenoid sinus, maxillary sinus, and nasopharynx are easily approached by an endoscope. Lateral rhinotomy have to make facial incision and affects maxillary bone development. We combined the craniotomy and endoscopic approach intending to take advantages of the two approaches.

METHODSTwelve NPF patients who underwent craniotomy with endoscopic assistance from March 2002 to July 2008 at the Beijing Tongren Hospital were selected. All patients were male. Their ages ranged from 11 to 33 years. The main symptoms were visual deterioration, exophthalmos, nasal obstruction, epistaxis and pharynx nasalis neoplasm. The diagnosis was based on CT, MRI and digital subtraction angiography (DSA). All patients had intracranial encroachment and all underwent DSA and embolism treatment were taken before surgery. Seven patients had a pterional craniotomy, five had a frontal-temporal-orbital-zygomatic craniotomy. Most of the tumor was resected piecemeal, then removed through the sphenoidal sinus. Finally, using an endoscope in the nasal cavity, tumor in nasal cavity was resected and removed through the sphenoidal sinus, observing the dead angle of the craniotomy and confirming that sinus drainage was unobstructed.

RESULTSThe tumor was removed completely in 11 patients and partially resected in one patient because of hemorrhage. One patient had an infection after the operation and one patient had cerebrospinal rhinorrhea 3 years after surgery that was remediated by endoscopic repair.

CONCLUSIONCraniotomy with endoscopic assistance in the treatment of NPF was minimally invasive, safe and efficient, and avoided facial incision.

Adolescent ; Adult ; Child ; Child, Preschool ; Craniotomy ; adverse effects ; methods ; Endoscopy ; adverse effects ; methods ; Fibroma ; diagnostic imaging ; pathology ; surgery ; Humans ; Magnetic Resonance Imaging ; Male ; Nasopharyngeal Neoplasms ; diagnostic imaging ; pathology ; surgery ; Radiography ; Young Adult

OBJECTIVETo study the clinicopathologic characteristics, immunophenotype and differential diagnosis of superficial acral fibromyxoma (SAF).

METHODSThe clinical, pathologic and immunohistochemical features of a case of SAF occurring in left middle finger was studied, with review of literature.

RESULTSThe patient was a 62-year-old male who presented with a solitary painful nodule located in the distal aspect of his left middle finger. The nodule lied close to the nail bed and deep to the underlying periosteum. Grossly, the tumor was poorly circumscribed, measured 2 cm in greatest dimension and had a greyish-white cut surface and rubbery consistency. On low-power examination, the tumor was centred in the dermis and displayed a vague lobular pattern. The tumor cells were spindled to stellate in shape and associated with myxoid matrix. Focal fascicular or loose storiform patterns were also noted. A delicate vascular network was identified in the myxoid stroma. Mast cells were readily observed. On high-power examination, the tumor cells were relatively bland-looking and showed at most a mild degree of nuclear atypia. Mitotic figures were rare and coagulative tumor necrosis was absent. Immunohistochemical study showed that the tumor cells were positive for vimentin, CD34 and CD99. Focal staining for CD10 was also demonstrated. Other immunomarkers including actins, desmin and epithelial membrane antigen were negative.

CONCLUSIONSSAF is a distinctive soft tissue tumor occurring mainly in the digits of adults. Awareness of this entity is helpful in distinguishing SAF from other myxoid soft tissue tumors occurring there. Complete excision with clear resection margins is the mainstay of treatment.

12E7 Antigen ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Dermatofibrosarcoma ; metabolism ; pathology ; Diagnosis, Differential ; Fibroma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Fingers ; pathology ; Follow-Up Studies ; Ganglion Cysts ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Nerve Sheath Neoplasms ; metabolism ; pathology ; Radiography ; Skin Neoplasms ; metabolism ; pathology ; Soft Tissue Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism