Misdiagnosed Recurrent Nodular Lesions of the Hand: A Case of Neurofibroma
A. Idrissi *
Department of Plastic Surgery, CHU La Rabta, Tunis, Tunisia.
Y. Trabelsi
Department of Plastic Surgery, CHU La Rabta, Tunis, Tunisia.
H. Amara
Department of Plastic Surgery, CHU La Rabta, Tunis, Tunisia.
R. Maala
Department of Plastic Surgery, CHU La Rabta, Tunis, Tunisia.
M. A. Sbai
Department of Plastic, Reconstructive and Aesthetic Surgery, Mohamed Taieb Maamouri University Hospital, Nabeul, Tunisia.
*Author to whom correspondence should be addressed.
Abstract
Aims: Describe the diagnostic evolution of a rare, recurrent soft tissue tumor of the hand, initially diagnosed as nodular fibromatosis and ultimately confirmed as neurofibroma.
Case Presentation: A 22-year-old female presented with multiple recurrences of a soft tissue mass in the right index finger over six years. Initial biopsies showed fibromatosis; final diagnosis was neurofibroma confirmed histologically in 2024.
Discussion: Neurofibroma, though benign, may mimic other fibroblastic lesions and can lead to delayed diagnosis, particularly in the absence of immunohistochemical analysis. Their localization in the hand is exceptional, representing only 0.8% of all neurofibromas in the general population and 10–15% among patients with neurofibromatosis type 1. Clinical features such as pseudo-Tinel’s sign and multifocal presentation should raise early suspicion for nerve sheath tumors.
Conclusion: Recurrent digital fibromatosis must prompt reevaluation, including immunohistochemistry. Early consideration of neurogenic tumors may prevent diagnostic delays and functional morbidity.
Keywords: Nodular fibromatosis, neurofibroma, finger tumor, soft tissue mass, case report, hand surgery