Intratendinous Ganglion in the Extensor Pollicis Longus: A Case Report and Review of Literature.

We present the case of a 73-year-old woman with an intratendinous ganglion cyst occurring in the extensor pollicis longus (EPL) tendon of her right hand. The subcutaneous mass moved according to the movement of the EPL tendon of her right thumb. Magnetic resonance imaging showed a space-occupying lesion in the EPL tendon. Biochemical and hematoimmunological examinations ruled out diabetes mellitus, rheumatoid arthritis and other connective tissue diseases. She complained of a motion pain during thumb extension, and she had desired surgery. Intraoperatively, an intratendinous cyst was identified within the tendon substance of the EPL, in which a part of the cyst was herniated into a slit in the tendon substance, just distal to the extensor retinaculum without remarkable proliferative synovial tissue. The EPL tendon was opened longitudinally, and a cystic lesion was enucleated. The pathological findings showed that the cyst wall consisted of fibrous tissue with degeneration, lacking epithelial lining. Postoperative recovery was uneventful. Six months after surgery, the patient had no residual pain and cyst recurrence. The rarity of intratendinous ganglion cysts makes diagnosis and treatment challenging. Since intratendinous ganglion cysts and associated synovitis frequently weaken the structure of the affected tendons, prompt diagnosis and surgical excision are necessary. PMID: 32999177 [PubMed - as supplied by publisher]
Source: Journal of Nippon Medical School - Category: Universities & Medical Training Authors: Tags: J Nippon Med Sch Source Type: research