Endoscopic Assisted En-Bloc Resection of Thenar Vascular Leiomyoma

A range of neoplastic, inflammatory, traumatic, and degenerative pathologies may present with a mass in the thenar eminence. Vascular leiomyomas are infrequent benign soft-tissue neoplasms originating from the tunica media layer of venous wall vascular walls. Classically, vascular leiomyoma is treated by complete marginal excision with very rare recurrence rates after surgery. However, open surgery may result in a lengthy, disfiguring surgical scar. Endoscopic en-bloc tumor resection is a minimally invasive approach and can provide a whole block specimen for histologic examination. The purpose of this Technical Note is to describe the details of endoscopic-assisted en-bloc resection of thenar vascular leiomyoma. This minimally invasive approach can provide a whole block specimen for histologic examination and reduce tumor seeding as compared with endoscopic piecemeal resection of vascular leiomyoma.