The Desmoid Tumor Research Foundation

March 2019

Desmoid Fibromatosis in the Brachial Plexus Mimicking an Ulnar Nerve Entrapment

Author Information

Styring E(1), Ahlstrom M(2), Rissler P(3), Mertens F(4), Abul-Kasim K(5), Dahlin LB(6,7).

(1)Lund University, Skane University Hospital, Dept of Orthopedics, 221 85 Lund, Sweden. (2) Lund University, Skane University Hospital, Dept of Hematology, Oncology and Radiophysics, 221 85 Lund, Sweden. (3) Lund University, Skane University Hospital, Dept of Clinical Sciences Lund, Pathology, 221 85 Lund, Sweden. (4) Lund University, Skane University Hospital, Division of Clinical Genetics, 221 85 Lund, Sweden. (5)Dept of Radiology, Division of Neuroradiology, Lund University and Skane University Hospital, 205 01 Malmo, Sweden. (6)Dept of Translational Medicine – Hand Surgery, Lund University, 205 01 Malmo, Sweden. (7)Dept of Hand Surgery, Skane University Hospital, 205 01 Malmo, Sweden.

Publication

Am J Med Case Rpt

Summary

A 37-year-old man with type 1 diabetes mellitus was referred to the hand surgery unit due to increasing pain, numbness and weakness in his right arm developing over more than one year. An ulnar nerve neurography was inconclusive and the patient had a frozen shoulder on the right side. At examination, the clinical presentation did not correspond to an ulnar nerve entrapment why other causes were considered. A chest X-ray revealed a lesion in the apical part of the right lung. Consecutive CT scan, MRI and fine and core needle biopsies led to the diagnosis of a desmoid tumor. Surgery was deemed to be too mutilating and treatment was initiated with doxorubicin. Due to tumor and symptom progression the therapy was changed to PegIntron, then antiestrogen and NSAID and finally tyrosine kinase inhibitor (sorafenib) resulting in tumor shrinkage.

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