Presentation
Left anterior elbow lump for the last two months. No pain or restricted elbow movements. No trauma.
Patient Data
Anterior elbow single lesion (23 x 22 x 18 mm). A lobulated, well-defined, hypoechoic, mildly heterogeneous lesion in the intermuscular plane. Faint acoustic enhancement; no calcification, cystic changes, or vascularity. Lateral to the biceps distal tendon and to the brachialis distal muscle. Superficial to the supinator proximal edge. The lesion is close to but separate from the superficial sensory nerve and the posterior interosseous nerve (branches of the radial nerve).
The short-axis cine loop runs from the proximal to the distal direction.
The rest of the elbow examination was normal.
The first photo shows an explored lesion in the anterior elbow. The second photo shows an excised lesion. The third photo shows the operative site after the lesion excision.
Case Discussion
A young male with an anterior elbow painless lump without distal neurological symptoms. The ultrasound revealed an intermuscular plane lesion separate from the superficial sensory and posterior interosseous branches of the radial nerve. Similar imaging findings in the MRI (not uploaded, no copyright) A nerve sheath tumor was suspected in both modalities.
Surgical exploration revealed the lesion was separate from the radial nerve branches. Excision was done. The histopathology diagnosis was a collagenized nerve sheath tumor, probably a neurofibroma.
Intraoperative photos courtesy of operating surgeon Dr. Ritesh Patel
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