Nodulo Solido Brazo & Enfermedad Ledderhose

julio 06, 2018

Femenina 69 anos edad, diabetica no insulino dependiente desde hace 7 anos que presenta nódulo redondeado,que se moviliza con la palpación, se localiza en tercio medio de cara interna del brazo derecho.Ha desarrollado dolor leve en la zona.En ambas plantas de los pies presenta sendos nódulos dolorosos,palpables,no móviles,dolorosos a la palpación y con dolor que se intensifica con la deambulacion. El examen sonografico del nódulo del brazo muestra área hipoecogenica redondeada con punto de calcificacion en la zona central que produce sombra ecogenica posterior,muestra limites precisos, se localiza por debajo de la fascia posterior del tejido muscular, deformándola,mide aprox: 2,13 X 1,59 X 1,50. Se aprecia flujo negativo al Doppler Color y Score 2 con la Elastografia.El examen de ambas plantas de los pies muestra sendos nodulos solidos hipoecogenicos de limites mas o menos regulares con flujos negativos al Doppler Color y Elastografia con Score 2, miden aprox: 1,21 X 0,46 en el derecho y 0.83 X 0,32 cm en el izquierdo. Se concluye con los diagnósticos de Nódulo Solido Brazo Derecho,posiblemente Neurofibroma Vs Schawannoma Vs Miositis Proliferativa, diagnósticos diferenciales a ser determinados post-biopsia / extracción de material de las lesiones y Fibromatosis Plantar ( Enfermedad de Ledderhose ) de las plantas de los pies.

Solid Node Arm & Disease of Ledderhose

Female 69 years of age Diabetic non-insulin-dependent for 7 years that presents rounded, hard nodule, which is mobilized with palpation, is located in the middle third of the inner side of the right arm. She has developed mild pain in the area. In both soles of the feet presents painful nodules, palpable, not mobile, painful on palpation. The patient reports that the pain intensifies with walking.
The sonographic examination of the nodule of the right arm shows a hypoechogenic nodule, rounded with a small area of central calcification that produces a posterior echogenic shadow, the nodule shows precise limits, is located below the posterior fascia of the muscular tissue, deforming it, measures approx: 2.13 X 1.59 X 1.50 cm. It presents negative flow to Doppler Color and Score 2 -Benign to the exam with Elastography.
The examination of both soles of the feet shows the presence of solid, hypoechogenic nodules of more or less regular limits, with negative flows to Doppler Color and Elastography with 2-benign Score-measure approx: 1.21 X 0.46 cm on the right and 0.83 X 0.32 cm on the left.

We conclude with the diagnosis of a solid nodule in the right arm, possibly Neurofibroma Vs Schwannoma Vs Proliferative myositis, differential diagnoses to be determined post-biopsy / removal of material from the lesion and Plantar Fibromatosis (Ledderhose disease) of both feet plants.