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Case Reports
. 2008 Nov;466(11):2892-8.
doi: 10.1007/s11999-008-0159-x. Epub 2008 Feb 21.

A 56-year-old woman with a right arm mass

Panayiotis J Papagelopoulos  1 , Andreas F Mavrogenis, Evangelia Skarpidi, Irene Nikolaou, Panayotis N Soucacos
Affiliations
Case Reports

A 56-year-old woman with a right arm mass

Panayiotis J Papagelopoulos et al. Clin Orthop Relat Res. 2008 Nov.
No abstract available

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Figures

Fig. 1
Fig. 1
A 56-year-old woman presented with a soft, oval, deep palpable mass on the medial side of her right arm with a maximum diameter of 4 cm.
Fig. 2
Fig. 2
An anteroposterior plain radiograph of the right humerus shows round calcifications on the medial side of the right middle arm.
Fig. 3
Fig. 3
Ultrasonography of the right arm shows a 40- × 21-mm well-defined oval mass with heterogeneous internal echogenicity and moderate vascularity. The mass is closely related to the median nerve (arrow) that shows flattening, distortion of architecture, and altered echogenicity.
Fig. 4A–D
Fig. 4A–D
MR images show a fusiform lesion with well-circumscribed borders at the posteromedial aspect of the biceps, along the expected course of the median nerve. The lesion is heterogeneous and isointense or slightly hypointense to muscle on (A) T1-weighted axial and (B) T1-weighted sagittal images. On postcontrast (C) T1-weighted axial and (D) T1-weighted sagittal images, the mass enhances in fairly uniform fashion.
Fig. 5A–C
Fig. 5A–C
(A) Histologic sections of the biopsy specimen show a proliferative vascular lesion composed of thin-walled vascular channels in a focally hyalinized stroma with areas of hemorrhage. The vascular channels are lined by endothelial cells without nuclear atypia (Stain, hematoxylin and eosin; original magnification, ×400). (B) CD34 immunoperoxidase stain highlights the vascular nature of the lesion (Original magnification, ×100). (C) The thrombosed cavernous lesion developed papillary endothelial hyperplasia as an exuberant response to organizing thrombus. Embolism material was surrounded by foreign body giant cell reaction (Stain, hematoxylin and eosin; original magnification, ×100).
Fig. 6A–B
Fig. 6A–B
(A) MR and (B) conventional angiograms show a well-vascularized lesion with discrete margins. The arterial supply appears to originate from the brachial artery and venous drainage is through small branches of the brachial and basilic veins. Small defects in the contrast column correlate with the phleboliths identified on the other imaging studies.
Fig. 7A–B
Fig. 7A–B
(A) Surgical exploration of the middle arm revealed a dark-red fusiform tumor that distended the trunk of the median nerve. (B) The perineurium was incised, and the tumor was resected through intraneural microdissection.
See this image and copyright information in PMC

References

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