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Epithelioid Sarcoma of the Forearm Arising from Perineural Sheath of Median Nerve Mimicking Carpal Tunnel Syndrome

By Hiromasa Fujii, Kanya Honoki, Hiroshi Yajima, Akira Kido, Yasunori Kobata, Daisuke Kaji and Yoshinori Takakura


We report here a case of epithelioid sarcoma in the forearm of a 33-year-old male presenting with symptoms and signs of carpal tunnel syndrome originating from the direct involvement of the median nerve. Due to the slow growing of the tumor, the patient noticed the presence of tumor mass in his forearm after several months from the initial onset of the symptoms. Magnetic resonance imaging showed an 8 × 4 cm mass involving the median nerve in the middle part of the forearm, and histological analysis of the biopsy specimen revealed the diagnosis of epithelioid sarcoma. Radical surgical resection was performed in conjunction with adjuvant chemotherapy. The function of the flexors were restored by the multiple tendon transfers (EIP → FDS; ECRL → FDP; BrR → FPL; EDM → opponens) with superficial cutaneous branch of radial nerve transfer to the resected median nerve. The function of the affected hand showed excellent with the DASH disability/symptom score of 22.5, and both the grasp power and sensory of the median nerve area has recovered up to 50% of the normal side. The patient returned to his original vocation and alive with continuous disease free at 3.5-year follow-up since initial treatment

Topics: Case Report
Publisher: Hindawi Publishing Corporation
OAI identifier:
Provided by: PubMed Central

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  1. (1977). A .G .H u v o s ,G .R o s e n ,a n dR .C .M a r c o v e ,“ P r i m a r y osteogenic sarcoma: pathologic aspects in 20 patients after treatment with chemotherapy en bloc resection, and prosthetic bone replacement,”
  2. (1996). Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder, and head),”
  3. (2001). Diagnostic imaging of tumors of the hand and wrist,”
  4. (2002). Epithelioid sarcoma of the extremities: a dismal long-term outcome,”
  5. (2007). Epithelioid sarcoma of the median nerve mimicking a peripheral nerve sheath tumour,”
  6. (2002). Epithelioid sarcoma of the sciatic nerve perineural sheath: a mimic of nerve sheath tumor,”
  7. (1989). Epithelioid sarcoma,”
  8. (1996). Epithelioid sarcoma: a clinicopathologic review of 55 cases,”
  9. (1970). Epithelioid sarcoma: A sarcoma simulating a granuloma or a carcinoma,”
  10. (1999). Epithelioid sarcoma: an immunohistochemical analysis of 112 classical and variant cases and a discussion of the differential diagnosis,” Human Pathology,
  11. (2002). Epithelioid sarcoma: clinical, MR imaging and pathologic findings,”
  12. (1985). Epithelioid sarcoma: diagnosis, prognostic indicators, and treatment,”
  13. (1988). Epithelioid sarcoma. An analysis of fifty-one cases,”
  14. (2008). Functional reconstruction of traumatic loss of flexors in forearm with gastrocnemius myocutaneous flap transfer,”
  15. Functioning free-muscle transplantation for the upper extremity,”
  16. (1996). Reconstruction following resection of malignancies of the upper extremity,”
  17. (2006). Reconstruction of the hand and upper extremity after tumor resection,”

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