Supracubital perineurioma misdiagnosed as carpal tunnel syndrome: case report.
BACKGROUND
Perineuriomas have been defined as tumorous lesions of the peripheral nerves which derive from perineurial cell proliferation and may be associated with abnormalities on chromosome 22.


METHODS
Three years after a painful cubital vein procaine injection, a 33 year-old man developed a median nerve lesion, initially diagnosed as carpal tunnel syndrome. Symptoms progressed despite appropriate surgery. Clinical and electrophysiological re-evaluation revealed a fusiform mass at the distal upper arm, confirmed by MRI. Immunohistochemical studies classified the tumor as a mixed perineurioma and neuroma.


CONCLUSIONS
Perineurioma mixed with neuroma may potentially caused by the previous trauma or cytotoxic effects of procaine.
Saft
Carsten
C
Department of Neurology, St, Josef Hospital, Ruhr-University Bochum, Germany. carsten.saft@ruhr-uni-bochum.de
Andrich
Juergen E
JE
Neuen-Jacob
Eva
E
Schmid
Gebhard
G
Schols
Ludger
L
Amoiridis
Georgios
G
D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008475:Median Nerve / Q000293:injuries / Q000473:pathology* / Q000601:surgery; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D010146:Pain / Q000209:etiology; D011343:Procaine / Q000009:adverse effects; D013497:Sural Nerve / Q000637:transplantation
D011343:Procaine