A painless finger mass.

A 39-year-old gentleman presented with a painless finger mass that had increased in size over eight years. There was no history of trauma or injury. He denied having any numbness or tingling in his fingers. No similar masses were present elsewhere. Past medical and family histories were non-contributory. Physical examination revealed a non-tender soft mass on the extensor aspect of the right fifth middle phalanx which transilluminated (Figure 1A). Neurological examination including digital sensory and motor functions was normal. The radiograph showed a non-invasive soft tissue mass on the dorsal aspect of the fifth middle phalanx (Figure 1B). An aspiration attempt with an 18-gauge needle did not recover any fluid from the mass. The patient underwent a surgical resection by an orthopaedic hand surgeon. The extensor mechanism was noted to be attenuated with a large subtendinous encapsulated mass extending on the lateral sides of the digit. A 2 x 1 x 0.8 cm mass was carefully mobilized and completely excised. There was a large depression on the dorsal surface of the middle phalanx consistent with longstanding pressure on the bone with no invasive features.