A rare case of concurrent osteochondroma and lipofibromatous hamartoma in the hand

Abstract

Background: Tumours affecting the hand are not uncommon and can represent a variety of different pathologies, though certain tumour types are far less frequent. They can present with pain, a mass, or symptoms from compression of surrounding structures. We present a case of two tumours rarely seen in the hand occurring concurrently and in close proximity. Case report: A 45-year-old female presented with painful paraesthesia of the thumb, index, and middle fingers, associated with a mass in the palm. She was initially diagnosed with carpal tunnel syndrome and underwent decompression at another institution, however her symptoms persisted warranting referral to our hand clinic. Further investigation revealed two lesions: an osteochondoma of the proximal phalanx and a lipofibromatous hamartoma of the common digital nerve. Management consisted of excision of the bony lesion and expectant management of the nerve tumour. Conclusion: We have presented a case of two rarely seen hand tumours, occurring simultaneously and both contributing to presenting symptoms. This posed challenges in both diagnosis and treatment. Appropriate investigation and a multidisciplinary approach involving surgeons, radiologists, and pathologists was essential for formulating a management plan in this unusual case.