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Case Reports
. 2012 Jan 19;7(1):1.
doi: 10.1186/1749-7221-7-1.

Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

Kiyoshi Okada  1 , Junichi Miyake, Toshiyuki Kataoka, Hisao Moritomo, Tsuyoshi Murase, Hideki Yoshikawa
Affiliations
Case Reports

Median nerve neuropathy in the forearm due to recurrence of anterior wrist ganglion that originates from the scaphotrapezial joint: Case Report

Kiyoshi Okada et al. J Brachial Plex Peripher Nerve Inj. .

Abstract

Background: Median nerve neuropathy caused by compression from a tumor in the forearm is rare. Cases with anterior wrist ganglion have high recurrence rates despite surgical treatment. Here, we report the recurrence of an anterior wrist ganglion that originated from the Scaphotrapezial joint due to incomplete resection and that caused median nerve neuropathy in the distal forearm.

Case presentation: A 47-year-old right-handed housewife noted the appearance of soft swelling on the volar aspect of her left distal forearm, and local resection surgery was performed twice at another hospital. One year after the last surgery, the swelling reappeared and was associated with numbness and pain in the radial volar aspect of the hand. Magnetic resonance imaging revealed that the multicystic lesion originated from the Scaphotrapezial joint and had expanded beyond the wrist. Exploration of the left median nerve showed that it was compressed by a large ovoid cystic lesion at the distal forearm near the proximal end of the carpal tunnel. We resected the cystic lesion to the Scaphotrapezial joint. Her symptoms disappeared 1 week after surgery, and complications or recurrent symptoms were absent 13 months after surgery.

Conclusions: A typical median nerve compression was caused by incomplete resection of an anterior wrist ganglion, which may have induced widening of the cyst. Cases with anterior wrist ganglion have high recurrence rates and require extra attention in their treatment.

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Figures

Figure 1
Figure 1
Magnetic resonance imaging results. (A, B) T2-weighted fat-suppressed magnetic resonance image showing origination of the multicystic lesion (arrow) from the Scaphotrapezial joint (A; arrow head) and expansion to the distal forearm beyond the wrist (B).
Figure 2
Figure 2
Intraoperative view of the distal forearm showing (A) the median nerve (arrow head) compressed by the large ovoid cyst (arrow) and (B) the large ovoid cyst expanded to the volar of the forearm passing between the flexor carpi radialis (*) and flexor digitorum superficialis (*).
See this image and copyright information in PMC

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