RESUMO
Juvenile hyaline fibromatosis is a rare disorder characterized by an extracellular accumulation of hyaline deposit. In the extremities, lesions may remain quiescent or gradually increase in size, eventually resulting in skin ulceration. There is no curative treatment. Surgery may allow some recovery of function, but recurrence is possible. We report a case of juvenile hyaline fibromatosis in both hands of a 25-year-old man who required multiple surgical procedures to address problems with function, pain, and appearance.
Assuntos
Fibroma , Síndrome da Fibromatose Hialina , Neoplasias Cutâneas , Adulto , Mãos/patologia , Mãos/cirurgia , Humanos , Hialina , Síndrome da Fibromatose Hialina/diagnóstico , Síndrome da Fibromatose Hialina/patologia , Síndrome da Fibromatose Hialina/cirurgia , Masculino , Dor , Extremidade Superior/patologiaRESUMO
CASE: We reported a dynamic neurogenic left thoracic outlet syndrome (TOS) with a permanent abduction of the fifth left finger. Preoperative magnetic resonance imaging (MRI) assessed the presence of subclavius posticus muscle (SPM). Because of a nonoperative treatment failure, we performed a brachial plexus neurolysis and SPM resection. Immediate postoperative assessment showed an immediate disappearance of the Wartenberg sign. CONCLUSION: SPM constitutes an underestimated cause of TOS. A careful MRI reading is necessary to make correct diagnosis. Nonoperative treatment includes physiotherapy and can be proposed in first instance. When nonoperative treatment fails, brachial plexus exploration with release of the SPM may result in resolution of symptoms.
