A 38-year-old male, prese...

A 38-year-old male, presented with complaints of intermittent right wrist pain and tingling sensations in the right thumb, index, and middle fingers for the past 6 weeks. The symptoms had a gradual onset and worsened progressively, prompting him to seek medical attention. The patient denied any history of preceding trauma, fever, multiple joint pain, or morning stiffness. Additionally, there was no past medical history of any significant illnesses. Upon physical examination, a mild, diffuse fullness was noted over the volar aspect of the right wrist. Deep palpation revealed mild tenderness in the same area, with no local rise in temperature. Resisted active finger flexion elicited pain over the wrist. Tinel's sign was positive, indicating irritation of the median nerve, and Phalen's test was also positive, suggesting carpal tunnel compression. The range of motion at the wrist was comparable to the left wrist, and no hypoesthesia or motor weakness was observed during the neurological examination. Laboratory analysis showed a leucocyte count of 4490/cumm (normal range: 4000–11 000), erythrocyte sedimentation rate of 15 mm/hour, and a C-reactive protein level of 4 mg/L, all within normal limits. A sensory nerve conduction study was performed, which revealed increased distal latency, decreased amplitude, and decreased conduction velocity of the median nerve around the wrist. Immunohistochemical staining showed positive smooth muscle actin expression and negative staining for S100 protein, desmin, myogenin, CD34, β-catenin, STAT6, Pan-cytokeratin, epithelial membrane antigen, and Bcl2. The MRI was performed for further diagnosis.