Bilateral wrist masses as first manifestation of wild-type transthyretin amyloidosis in a case with recurrent carpal tunnel syndrome: a case report

BACKGROUND: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy in the general population. Recurrent bilateral CTS could be the first manifestation of a more serious systemic disease, such as amyloidosis, which would help with early diagnosis and prevent mortality and morbidity associated with this illness. CASE PRESENTATION: We present a rare case of a 75-year-old Middle Eastern man suffering from bilateral wrist edema with weakness and numbness of both hands and a history of recurrent bilateral CTS. The bilateral wrist masses were revealed at the MRI investigation. He was treated with surgical resection, and amyloid deposits were confirmed with pathology evaluation. He remains symptom-free after 4 years of follow-up. CONCLUSION: This case reinforces that forearm masses in the context of recurrent CTS should prompt evaluation for amyloidosis. Early biopsy and systemic workup can lead to timely diagnosis, improve prognosis, and guide targeted therapies. Future research should explore screening protocols for amyloidosis in high-risk CTS populations.