gms | German Medical Science

Objectives/Interrogation: The study's aim was to review the literature regarding the epidemiological, clinical, radiological, and histological characteristics of the Pacinian corpuscle neuromas (hyperplasia) and neurofibromas in the hand and fingers, in order to support clinicians in managing tumors responsible of unclear symptomatology in the hands and fingers.

Methods: A search of PubMed, Medline, Embase, Cochrane, and Google Scholar databases was undertaken, without restriction on date, language or publication status. The mesh terms used were "pacinian" or "pacini", "tumor" or "corpuscle tumor" or "neuroma" or "hyperplasia" or "hypertrophy" or "pacinioma" or "neurofibroma", and "hand" or "finger". Of the 1050 articles found, 67 met the inclusion criteria. Among these, 55 articles referred to Pacinian tumors at the level of the hands and fingers, and 12 articles referred to anatomical, histopathological, radiological and immunohistochemical studies regarding the Pacinian corpuscles without reporting a specific clinical case. All the case reports and cases series included in our final selection were evaluated for quality assessment by the first and last authors.

Results and Conclusions: A total of 72 tumors affecting the Pacinian corpuscles of the hand and fingers were identified, among which 58 cases (80.6%) were labeled as Pacinian corpuscles neuroma or hyperplasia (PCNH) and 14 cases (19.4%) as Pacinian corpuscle neurofibroma (PCNF). To the best of our knowledge, this is the largest review published. We found statistically significant difference between PCNH and PCNF in terms of age of appearance (50.2 vs. 31.1 years, p = .001), presence of pain (84.6% vs. 40%, p = .002), of sensory changes (57.9% vs. 0%, p = .027), of a visible or palpable mass (48% vs. 85.7%, p = .012), and history of trauma (64.2% vs. 12.5%, p = .006). Furthermore, the recurrence rate is not insignificant (21.2% for PCNH and 50% for PCNF, p = .244).

In conclusion, PCNH and PCNF behave differently with respect to their epidemiological and clinical presentation. Imaging may support the differential diagnosis with other common painful lesions of the hand. These findings are in contrast with previous reports, which decried the value of clinical signs in favor of a diagnosis mostly based on the histological examination. Accurate anamnestic data collection and clinical examination are essential to differentiate these conditions, while pathology tests are important to confirm the diagnosis.