Journal of Orthopaedic Reports (Sep 2023)
A rare non-oncologic soft tissue lesion of the forearm: Case report
Abstract
Background: A wide variety of benign and nonneoplastic, cystic or solid, soft tissue tumors are commonly detected in the forearm, wrist and hand. Small subcutaneous masses are often excised without imaging studies. Case report: A 63-year-old woman was referred for surgical removal of a subcutaneous well-circumscribed, soft, compressible, painless, and nonpulsatile mass on the volar aspect of her right distal forearm. The lesion had been studied with plain radiographs and magnetic resonance imaging, which indicated a potential peripheral nerve or vascular tumor. A preoperative ultrasound diagnosed a patent ulnar artery aneurysm containing thrombus. Further noninvasive angiographic imaging confirmed the diagnosis and showed ulnar artery dominance in the hand. Conclusion: The differential diagnosis of the nonneoplastic soft tissue tumors of the forearm should be widened to include the nonpulsatile idiopathic true patent ulnar artery aneurysm. The appearance of this rare entity in a patient with ulnar artery dominance in the hand, and, furthermore, in association with an obscure congenital or acquired insufficiency of the ipsilateral radial artery, could reasonably be considered as the worst nononcologic case scenario of a forearm soft tissue tumor since misdiagnosis and inappropriate treatment may lead to devastating iatrogenic complications.
