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A 61 year old man presented with a 6 months history of intermittent paraesthesia and numbness in the first three radial digits of the right hand. Initially, the symptoms occurred during his activity as masseur when performing vigorous movements of the elbow. Later, a pea sized mass could be palpated at the distal medial upper arm. The electrophysiological examination was normal. High resolution ultrasonography demonstrated a 2 cm by 1 cm ovoid structure (fig 1, white arrow) in the continuity of the median nerve (arrowheads). On operation a soft mass growing diffusely among the median nerve fascicles could be microscopically excised (fig 2). The tumour was identified as a neurofibroma on pathological examination. Postoperatively the patient experienced a full relief of symptoms with normal motor and sensory function of the median nerve.
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