As the mass was dissected further,
it was found to arise from a thick solid layer of inflammatory tissue which
involved the deep flexors and pronator quadratus. Flexor tendons were placed
under traction to allow a distal synovectomy without having to fully reopen
the carpal tunnel. Pathology was interpreted as nonspecific acute and chronic
inflammation, and all cultures (bacteria, fungus, mycobacteria) were negative.
Rheumatologic evaluation was negative, and there has been no recurrence
over a two year followup. The etiology remains obscure. |