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Ultrasound-Guided Percutaneous Peripheral Nerve Stimulation for the Treatment of Chronic Intractable Pain Originating From a Lipofibromatous Hamartoma of the Median Nerve
This case report presents an application of peripheral nerve stimulation to the median nerve to treat a patient with intractable pain due to a lipofibromatous hamartoma of the left upper extremity. Ultra high-frequency ultrasound was used to determine the boundaries of the hamartoma. The patient then underwent an ultrasound-guided implantation of 2 stimulator electrodes distal to the elbow along the median nerve with stimulation coverage achieved at 1.2 and 1.4 mA, respectively. After an uneventful procedure, the pain score immediately decreased from 9 out of 10 to less than 6 on a numeric rating scale.An Extraosseous Ewing Sarcoma of the Index Finger Masquerading as a Benign Tumor
Ewing sarcoma is a malignant, small, round, blue cell tumor that often affects the long bones and pelvis. It is rarely seen in the bones of the hand. A minority of Ewing sarcoma cases arise in soft tissue. This case report details the clinical and radiological presentation of an extraosseous Ewing sarcoma of the index finger in a 22-year-old woman. Treatment consisted of an index ray amputation followed by adjuvant chemotherapy. After 1 year, the left hand had excellent function with an acceptable cosmetic appearance and no evidence of metastasis or local recurrence.
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