Diagnosis and Surgical Management of a Solitary Fibrofatty Lesion of the Finger Mimicking Pachydermodactyly.
Yunfa Yuan, Qiang Chen, Ben Fan et al.
✦ AI-curated · Sources linked
Case in brief
A 30-year-old man had progressive, painless enlargement around the proximal interphalangeal joint of his right middle finger after long-term repetitive mechanical stimulation. Examination, laboratory tests, radiography, and ultrasonography showed a chronic non-inflammatory soft-tissue lesion without joint destruction or inflammatory arthropathy. Excision was undertaken because of enlargement, cosmetic concerns, and diagnostic uncertainty. Histology showed benign fibrofatty proliferation incorporating peripheral nerve bundles, without malignancy; the findings were not characteristic of classical pachydermodactyly. Healing was satisfactory, finger motion was preserved, contour improved, and no recurrence was seen during available follow-up.
What made this case unusual
The solitary lesion clinically resembled pachydermodactyly, which typically involves multiple fingers, but its histopathology was not characteristic of that disorder and instead favored a benign solitary fibrofatty proliferative lesion.
Diagnostic / clinical pearl
When a solitary digital soft-tissue lesion resembles pachydermodactyly, clinical appearance alone may not establish the diagnosis; histopathology and clinicopathological correlation can distinguish it from classical pachydermodactyly.