Misdiagnosed Recurrent Nodular Lesions of the Hand: A Case of Neurofibroma

Abstract

Aims: Describe the diagnostic evolution of a rare, recurrent soft tissue tumor of the hand, initially diagnosed as nodular fibromatosis and ultimately confirmed as neurofibroma. Case Presentation: A 22-year-old female presented with multiple recurrences of a soft tissue mass in the right index finger over six years. Initial biopsies showed fibromatosis; final diagnosis was neurofibroma confirmed histologically in 2024. Discussion: Neurofibroma, though benign, may mimic other fibroblastic lesions and can lead to delayed diagnosis, particularly in the absence of immunohistochemical analysis. Their localization in the hand is exceptional, representing only 0.8% of all neurofibromas in the general population and 10–15% among patients with neurofibromatosis type 1. Clinical features such as pseudo-Tinel’s sign and multifocal presentation should raise early suspicion for nerve sheath tumors. Conclusion: Recurrent digital fibromatosis must prompt reevaluation, including immunohistochemistry. Early consideration of neurogenic tumors may prevent diagnostic delays and functional morbidity.