Congenital aneurysm of the palmar digital artery: A case report and literature review

Abstract

Spontaneous arterial aneurysms of the hand are uncommon but are well-described in the adult population. In the pediatric population, however, congenital or true aneurysms of the hand are exceptionally rare. A case report and a literature review were performed for published cases of arterial aneurysms of the hand in the pediatric population. A 13-month-old child presented with an aneurysm of the common digital artery and underwent surgical excision without need for reconstruction. Literature review found 13 documented cases. Patient characteristics and management strategies were summarized. There are very few documented cases of hand arterial aneurysms in the pediatric population, with our patient being the third youngest ever reported. No cases were associated with hereditary disease, and aneurysm excision was performed in all cases. Our report highlights the need to include arterial aneurysm in a differential diagnosis when evaluating a pediatric patient with a palpable hand mass.

Pseudoaneurysm of the Superficial Palmar Arch in a 6-month-old Child: A Case Report

“…Out of 14 arterial pediatric hand aneurysms reviewed by Dean et al, five required reconstruction. 3 All of them were located in the ulnar artery. None of the lesions involving the common digital artery or the palmar arch required reconstruction, as was the case in our patient.…”

“…1 The small-caliber arteries of the hand distend only under high pressures, and in the setting of penetrating trauma, they are much more likely to be fully transected. 3,4 Pseudoaneurysms in children almost exclusively occur as a result of a penetrating trauma. True aneurysms occur as a result of repetitive blunt trauma, connective tissue disease, vasculitis, infection, or may be sporadic.…”

“…Ultrasound is the most common diagnostic imaging tool utilized but is frequently misleading, and supplemental advanced imaging such as angiogram or MRI is necessary to narrow the diagnosis. 3,9 In cases of completely thrombosed aneurysms with no flow, the ultrasound may show a well-defined, heterogeneously echogenic, nonvascular lesion resembling a soft-tissue tumor, a tumor-like condition such as fibromatosis, or complex fluid collection such as hematoma or abscess. Similarly, MRI of a thrombosed aneurysm may show heterogeneously high T2-W/STIR signal and peripheral enhancement.…”

A case of congenital aneurysm of the ulnar artery of the palm

“…In Japan, 12 reports have been published on aneurysms in the palm, of which 10 were caused by trauma, one had unknown etiology, and only one was diagnosed by Okuda et al [1] as a congenital aneurysm. In the English literature, we found only 14 reports on aneurysms in the palm [2,3,15] , five of which were diagnosed as congenital aneurysm but with underlying arteriosclerosis. Most aneurysms were caused by blunt trauma, especially those located in the palm, and were thought to have arisen because the ulnar artery was sandwiched between the hamate bone and skin.…”

“…Among the 15 cases previously reported [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] , the site of occurrence was the ulnar artery in 10 cases, the common digital artery in four cases, and the palmar arch in one case; the ulnar artery was involved in 67% of cases [ Table 1]. Okuda et al .…”