Archives of Hand and Microsurgery

The Korean Society for Surgery of the Hand (대한수부외과학회)
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Microscopic Decompression of Digital Nerve Surrounded by Hemangioma: A Case Report

미세수술을 통하여 수지신경을 압박하는 혈관종을 성공적으로 제거한 증례 보고

  • Ko, Jun Gul (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jun Hyeok (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea) ;
  • Rha, Eun Young (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea) ;
  • Lee, Jun Yong (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea) ;
  • Yoo, Gyeol (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea) ;
  • Baek, Sang Oon (Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea)
  • 고준걸 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 김준혁 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 나은영 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 이준용 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 유결 (가톨릭대학교 의과대학 성형외과학교실) ;
  • 백상운 (가톨릭대학교 의과대학 성형외과학교실)
  • Received : 2018.09.12
  • Accepted : 2018.09.26
  • Published : 2018.12.01
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Abstract

Hemangiomas are benign neoplasms of endothelial cells origin, rarely found in hand region. Authors report a 62-year-old female with capillary hemangioma of right index finger causing a neuropathic symptom via nerve compression. A space-occupying vascular lesion surrounding the radial digital nerve was revealed in magnetic resonance imaging (MRI), which was removed under microscopic assist. The digital nerve was decompressed consequently. The mass was firmly attached to both the digital nerve and digital artery, requiring a meticulous microscopic dissection to preserve the nerve and artery. Compression neuropathy caused by space-occupying lesions is rare and its diagnosis is often difficult. A microscopic surgical approach can be used to successfully relieve neuropathic pain after proper diagnosis established by diagnostic tools such as MRI as in this case.

혈관종은 내피세포로부터 기원한 양성종양의 일종으로, 수부에서는 드물게 발생하는 것으로 알려져 있다. 62세 여자환자로 우측 2수지 요골측의 통증을 주소로 내원하였으며, 시행한 자기공명영상에서 수지신경을 압박하는 것으로 보이는 혈관종이 의심되었다. 수술을 시행하여 요골측 수지신경 및 수지혈관을 압박하고 있는 혈관종을 확인하였으며, 수지신경 및 혈관을 가능한 보존하기 위하여 미세수술을 통해 혈관종을 제거하였다. 공간점유성 병변에 의한 압박성 신경병증은 드문 일로, 정확한 진단에 어려움이 있으나, 본 증례와 같이 자기공명영상을 통한 술 전 평가와 및 미세수술을 이용한 병변 제거 및 신경 보존을 통하여 신경병성 통증을 성공적으로 호전시킬 수 있을 것으로 생각한다.

Keywords

References

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