Compound Palmar Ganglion: A Case Report and Literature Review

Wali, Husseini; Al-Khuwaitir, S. A.; Hafeez, Mohamed A.

doi:10.5144/0256-4947.1986.55

Cited by 7 publications

(7 citation statements)

References 8 publications

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“…Thus, the diagnosis must be confirmed by biopsy and culture of the histopathological specimens, although these steps require a significant length of time and may delay diagnosis and treatment. Therefore, when the tentative diagnosis is tuberculous tenosynovitis, antibiotic treatment should be started while waiting for the results (7,14). However, anti-tuberculosis drugs often induce hepatic dysfunction (15,16), with elevation of biliary or hepatic enzymes (e.g., aspartate transaminase and alanine trans-aminase) being common in elderly patients (16).…”

Section: Discussionmentioning

confidence: 99%

Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

et al. 2018

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Despite the increasing incidence of tuberculosis, even in developed countries like Japan, tuberculoma is a relatively uncommon disease. Furthermore, given the rarity of tuberculoma, a definitive diagnosis is often delayed. We herein present the case of a 79-year-old man who presented with an erythematous and warm mass in the left forearm. Radiography revealed calcification of the wrist's volar side, and magnetic resonance imaging revealed a mosaic pattern at the lesion. Soft tissue sarcoma of the wrist was suspected, and an incisional biopsy was performed, which revealed numerous yellow rice bodies. A rapid pathological evaluation revealed caseous necrosis and Langhans giant cells, and a histological evaluation confirmed the diagnosis of tuberculoma. All the rice bodies were resected and the patient received postoperative antibiotic treatment with pyrazinamide, isoniazid, rifampicin and ethambutol. However, the patient developed hepatic insufficiency during treatment, and the regimen was discontinued. The patient had not experienced recurrence 1 year after the treatment. In conclusion, tuberculoma should be considered in the differential diagnosis of a wrist mass mimicking an inflamed soft tissue tumor.

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Section: Discussionmentioning

confidence: 99%

Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

et al. 2018

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“…Chronic flexor tenosynovitis of the hand is a rare condition in the present time. 1 Tuberculous tenosynovitis of the wrist is generally called compound palmar ganglion though ganglion is a misnomer. 1 It constitutes 5% of the total bone and joint tuberculosis infection.…”

Section: Descriptionmentioning

confidence: 99%

“…1 Tuberculous tenosynovitis of the wrist is generally called compound palmar ganglion though ganglion is a misnomer. 1 It constitutes 5% of the total bone and joint tuberculosis infection. 1 It presents with swelling of long duration with dull aching pain and few other symptoms at a very later stage.…”

Section: Descriptionmentioning

confidence: 99%

“…1 It constitutes 5% of the total bone and joint tuberculosis infection. 1 It presents with swelling of long duration with dull aching pain and few other symptoms at a very later stage. The most commonly affected sites are the ulnar or radial bursae of the hand.…”

Section: Descriptionmentioning

confidence: 99%

“…Most of the patients present with a dumbbell-shaped swelling across both sides of the flexor retinaculum with a positive cross fluctuation test. 1 They come very late for medical advice after the development of pain, discomfort, median nerve compression symptoms, 10 and restrictions of movement of fingers or wrists. Local signs of inflammations are very minor, 8 and have three stages.…”

Section: Descriptionmentioning

confidence: 99%

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Patient with tuberculous flexor tenosynovitis of the hand

et al. 2021

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Tubercular Tenosynovitis Mimicking a Large Ganglion Cyst

D’souza¹,

Joshi²,

Jeyaraman³

et al. 2022

JOCR

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Introduction: Tubercular tenosynovitis of the wrist and hand, although rare, presents a diagnostic dilemma primarily due to its non-specific clinical presentation, insidious course, and the large number of differentials that mimic it. When the diagnosis is late or delayed, significant bone and tendon complications occur. Large progressive swelling around the wrist in TB endemic countries should raise an early suspicion of being of tubercular etiology and should be high on the list of differential diagnoses. Case Report: A 48-year-old female presented with a large progressive swelling on the volar aspect of the left wrist and palm for 7 months, associated with increasing pain, stiffness, limited wrist range of movements, and weakened grip strength. Magnetic resonance imaging (MRI) revealed synovitis and fluid within flexor tendon synovial sheaths. The patient underwent an excision of the mass in toto and the cut section revealed an irregularly thickened wall with rice bodies within. Histopathological examination was indicative of a large ganglion cyst. GeneXpert MTB/RIF assay detected Mycobacterium tuberculosis. Despite histopathology being inconclusive, a diagnosis of TTS was considered due to the patient’s clinical presentation, MRI, and operative findings. The patient was started on an antitubercular drug regimen for a 1-year duration. The patient regained a complete range of movements of fingers and wrist and normal grip strength at the 3rd month follow-up. Conclusion: TTS is a challenging diagnosis entity. The diagnostic confirmation was achieved either by histopathology or detection of the organism either by culture or GeneXpert MTB/RIF assay. When the diagnosis is unsupported, drug therapy can be initiated empirically on strong suspicion of tuberculosis, especially in TB endemic areas.

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Compound Palmar Ganglion: A Case Report and Literature Review

Cited by 7 publications

References 8 publications

Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

Patient with tuberculous flexor tenosynovitis of the hand

Tubercular Tenosynovitis Mimicking a Large Ganglion Cyst

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