A 40-year-old woman presented with synchronous masses over the volar aspect of her left wrist and the radial side of her middle finger (Figure 1). Both masses were tender to palpation. Typical signs and symptoms of median nerve ompression were present, such as thenar atrophy, numbness in the median nerve distribution, a positive Tinel sign, and nocturnal pain. Electromyography demonstrated moderate median nerve compression at the wrist. Magnetic resonance imaging revealed a mass that was centrally located inside the median nerve in the distal one-third of the left forearm and another encapsulated lesion was seen arising from the radial digital nerve of the middle finger over the middle phalanx level. Surgical exploration showed encapsulated masses that were both compressing the nerve fibres centrally inside the perineural sheath. The proximal mass in the median nerve was removed completely (Figure 2). The digital nerve lesion required resection of a section of nerve and reconstruction with nerve grafting (Figure 3).
Histopathological assessment showed a diagnosis of schwannoma for both lesions.