Tumors of Hand and Distal radius
- Basal Cell Carcinoma:
- Chondrosarcoma: - the most common bony malignancy in the hand;
- CMC Boss: bony growth at bases of second and third metacarpals;
- special radiographs can demonstrate the osteophytes, which may be resected if symptoms warrent;
- associated with ganglia at least 30% of the time, and often associated with os styloideum (accessory ossicle);
- Enchondroma: (relatively common)
- Epidermoid Cyst (5-9%)
- Epithelioid Sarcoma:
- Fibroma (palmer surface)
- Fibrous Dysplasia
- Ganglionic cyst: (50%)
- Giant Cell Tumor of Bone: (occuring in distal radius);
- Giant Cell Tumor of the Tendon Sheath; (7-12%)
- Glomus Tumor
- Multiple digital glomus tumors.
- Hemangiomas 4-6%
- Malignant Melanoma (may be subungual)
- Surgical aspects of subungual malignant melanomas. The Scottish Melanoma Group.
- Metastatic Carcinoma:
- ref: Pain in the Thumb Related to Disease in the Lung
- Nerve Tumors:
- Lipoma: 1-6%
- Mucous Cyst
- Pigmented Villonodular synovitis
- Primary Lung Cancer (may involve DIP joint)
- Retinacular Cyst - located at the A1 pulley;
- treatment includes aspiration and removal of a window of the pulley if it recurrs;
- Squamous Cell Carcinoma:
- Synovial sarcoma
- Vascular Tumors:
- See: Vascular Problems of the Wrist and Hand:
- usually seen in long standing post mastectomy hymphedema
- initially bluish lesion which ulcerates
- rapid metastasis
- early radial amputation is indicated
- rapid growth, widely metastatic, proximal level amputation is recommended;
- prognosis is poor;
- False Aneurysm:
- does not include all layers of the arterial wall;
- can follow trauma late but may not have a bruit;
- True Aneurysm;
- AV fistula - may have bruit or thrill w/ decreased distal filling;
- assess the firmness and mobility of the mass as well as the ability of the mass to allow passage of light;
- a firm, non-mobile mass, which does not allow the passage of light should raise the suspicion of malignant tumor
Fibular reconstruction for giant cell tumor of the distal radius.
Acrometastases. A study of twenty-nine patients with osseous involvement of the hands and feet.
Giant-cell reparative granuloma of the hand and foot bones.
Distal ulnar translocation in the treatment of giant-cell tumors of the distal end of the radius.
Allogeneic bone in the treatment of tumors, trauma, and congenital anomalies of the hand.
Subungual exostosis in the hand.
Dermal angiomyoma of the upper extremity.
Treatment of soft-tissue sarcomas of the hand.
Primary malignant bone tumors of the hand.
Reconstruction of the distal aspect of the radius with use of an osteoarticular allograft after excision of a skeletal tumor.
Benign nerve tumors of the hand and the forearm.
Original Text by Clifford R. Wheeless, III, MD.
Last updated by Clifford R. Wheeless, III, MD on Tuesday, May 7, 2013 9:57 pm