Volar hand and wrist masses. There is a mass immediately volar to the radiocarpal joint arising from the median nerve measuring approximately 1.5 x 1.0 cm in the transverse dimension and just under 2 cm in the longitudinal dimension. The mass appears isointense to skeletal muscle on T1-weighted images, heterogeneously hyperintense on T2-weighted images, and demonstrates diffuse but heterogeneous enhancement following contrast administration. Although signal characteristics are not classical for nerve sheath tumor, this is the most likely diagnosis.There is a second mass with similar signal characteristics along the distal aspect of the thenar eminence measuring approximately 1.3 x 1.0 cm in the transverse dimension and 1.4 cm in the longitudinal dimension. A third mass with similar signal characteristics is situated within the subcutaneous fat volar to the sesamoid of the second metacarpal head and measures 0.8 x 0.6 cm in the transverse dimension and approximately 1.0 cm in the longitudinal dimension. We suspect that these masses also represent nerve sheath tumors presumably arising from a branch of the median nerve.We see no additional masses. The remaining soft tissues are unremarkable. Bone marrow signal is within normal limits. Mild osteoarthritis affects the basilar joint.
Three soft tissue masses as described above likely representing nerve sheath tumors in the median nerve distribution.