Atypical presentation of long-standing hand neurofibroma: A case report.

Introduction and importance: A solitary neurofibroma of the hand is an uncommon condition that typically lacks distinct symptoms, often resulting in misdiagnosis and prolonged morbidity. While it primarily affects younger individuals, it can also present in older adults. This article discusses an extraordinary case of a long-standing neurofibroma in the hand.

Case presentation: A 70-year-old right-handed individual, known to have hypertension and a pacemaker, presented with a mass on the palm of his left hand. This mass was associated with tingling and mild pain, particularly after excessive use of the hand. Recently, he had experienced partial limitations in hand movement due to the mass's pressure. Following a thorough clinical assessment, he underwent surgical excision of the mass under local anesthesia. Histopathological findings confirmed the diagnosis of neurofibroma. The follow-up was generally uneventful, apart from some persistent tingling sensations.

Clinical discussion: Solitary neurofibromas affecting small nerves are not frequently encountered in clinical practice and usually appear as a slowly progressive mass that may cause pain and tingling. There are no particular radiological approaches that can definitively diagnose this condition; however, histopathological findings have proven effective in confirming the diagnosis.

Conclusion: Long-term hand neurofibroma is an infrequent disorder that typically lacks prominent symptoms, highlighting the critical need for medical assessment. Surgery is the only effective treatment for hand cases, providing both a definitive diagnosis and the possibility of being performed with regional anesthesia.