medigraphic.com
ISSN 2007-8560 (Print)
Órgano Oficial de Difusión Científica de la Federación Mexicana de Colegios de Ortopedia y Traumatología, A.C. (FEMECOT)

2024, Number 4

<< Back Next >>

Ortho-tips 2024; 20 (4)

Diagnosis and treatment of soft tissue tumors of the hand in the population of the Hospital Regional de Alta Especialidad del Bajío

Sánchez GLE, Robles GJA, Amaro MO

Language: Spanish
References: 32
Page: 234-243
PDF size: 255.15 Kb.


ABSTRACT

Introduction: hand tumors, including skin cancers and others, require a multidisciplinary approach. Histological and radiological evaluation guides the diagnosis. Imaging techniques such as X-rays and magnetic resonance imaging are fundamental. Biopsy, reserved as a last resort, and its associated surgery are critical for accurate diagnosis and appropriate treatment. Objective: to describe the diagnoses of soft tissue tumors in the hand, as well as the treatment provided to the populyation belonging to the Hospital Regional de Alta Especialidad del Bajío. Material and methods: this study was observational, descriptive, and cross-sectional, conducted in a hospital between January 2014 and December 2017. It included patients with hand tumors, without restrictions by type, age, or gender, who had a confirmed diagnosis by pathology. The Quick DASH (Disability Arm-Shoulder-Hand) questionnaire was applied to assess disability. Statistical analyses were conducted using SPSS 21, using descriptive statistics for qualitative and quantitative variables, adjusting the presentation according to the normality of the data. Results: the study included 22 patients, 20 with benign tumors and two with malignant tumors. The most common benign tumors were synovial cysts (66.66% dorsal, 33.33% palmar). 9% presented malignant tumors, with squamous cell carcinoma and trichoblastic tumor. The predominant surgery was excisional biopsy (95.45%). The mean age was 43 ± 20.2 years, with a female predominance and greater involvement in the left extremities. The Quick DASH score was 11.3 ± 10.25% with no significant differences by gender or dominant extremity. Conclusions: the study results reflect similarity with worldwide literature regarding the incidence of benign and malignant tumors in the hand. Synovial cysts stand out as the most common tumor. The low incidence of malignant tumors represents a clinical challenge. The Quick DASH score suggests good manual function. It is proposed to expand the sample and conduct long-term follow-ups to improve the diagnosis and treatment of soft tissue tumors in the hand.


REFERENCES

  1. Edward A. Athanasian. Green's Cirugía de la Mano. Editorial Marban, 5ta edición. 2007. Capítulo 63: Tumores óseos y de tejidos blandos. Págs: 2211-2248.

  2. Ahmed A, El Gawad M, Amir M. Clinicopathological study of soft tissue tumors and tumorlike conditions around the wrist and the hand. EOA. 2017; 52 (3): 236-241.

  3. Khaled W, Drapé J. MRI of wrist and hand masses. SFR. 2015; 96 (12): 1238-1246.

  4. Lee S, Yoon S. Ultrasonographic and clinical characteristics of schwannoma of the hand. CiOS. 2017; 9 (1): 91-95.

  5. Iyengar R, Kiwanuka E, Mangray S, Cruz A, Katarincic J, Bhatt R. Diagnosis and management of dermatofibrosarcoma protuberans in a 3-year-old patient. JHS. 2017; 42 (9): 756.e1-756.e5.

  6. Hoellwarth J, Goitz R. Lipofibromatous hamartoma of the palmar cutaneous branch of the median nerve. JHM. 2018; 10 (02): 109-112.

  7. Chrisinger J, Salem U, Kindblom L, Amini B, Hansson M, Meis J. Synovial sarcoma of peripheral nerves. Am J Surg Pathol. 2017; 41 (8): 1087-1096.

  8. Bernstein K, Lattes R. Nodular (pseudosarcomatous) fasciitis, a nonrecurrent lesion: Clinicopathologic study of 134 cases. Cancer. 1982; 49 (8): 1668-1678.

  9. Pradhan A, Grimer R, Abudu A, Tillman R, Carter S, Jeys L, et al. Epithelioid sarcomas: how important is loco-regional control. EJSO. 2017; 43 (9): 1746-1752.

  10. Tripoli M, Cordova A, Moschella F. Characteristics, management techniques, and outcomes of the most common soft-tissue hand tumors. Ann Plast Surg. 2017; 79 (6): 558-565.

  11. Hoellwarth J, Goitz R. Lipofibromatous hamartoma of the palmar cutaneous branch of the median nerve. JHM. 2018; 10 (2): 109-112.

  12. Abdelshaheed M. Extensive intraneural fascicular dissection of a lipofibromatous hamartoma of the ulnar digital nerve of the thumb. Eur J Plast Surg. 2018; 41: 605-608.

  13. Tseng S, Hung J. Giant cell tumor of tendon sheath of the hand-a retrospective study. Indian J Surg. 2017; 80: 500-504.

  14. Singh A, Yadav N, Dogra B, Singh A. Giant cell tumor of tendon sheath. 2017; 4: 3785.

  15. Levi M, Crafton J. Rare giant cell tumor of the distal flexor digitorum longus tendon sheath and early diagnosis with use of magnetic resonance imaging. J Am Podiatr Med Assoc. 2017; 107 (4): 333-336.

  16. Stahl I, Calif E, Dreyfuss D. Multiple plexiform neurofibroma of the hand misdiagnosed as ganglion cyst. JHM. 2017; 9 (1): 45-46.

  17. Tsukamoto S, Takeda M, Honoki K, Omokawa S, Tanaka Y. Malignant granular cell tumor of the median nerve: a case report with a literature review of 157 cases. Skeletal Radiol. 2019; 48 (2): 307-316.

  18. Stemm M, Suster D, Wakely P, Suster S. Typical and atypical granular cell tumors of soft tissue. Am J Clin Pathol. 2017; 148 (2): 161-166.

  19. Yen H, Chiou H, Chou Y, Chen C, Guo W. Nodular fasciitis: sonographic– pathologic correlation. Ultrasound Med Biol. 2017; 43 (4): 860-867.

  20. Nicholson S, Milner R, Ragbir M. Soft tissue sarcoma of the hand and wrist: epidemiology and management challenges. JHM. 2018; 10 (2): 86-92.

  21. Ozturk R, Aydin M, Murat-Arikan S, Akif-Simsek M, Toptas E, Safak-Gungor B. Extremity soft tissue sarcomas of uncertain differentiation: presentation, treatment and outcomes in a clinical series of 60 patients. Bakirkoy Tip Derg/Med J Bakirkoy. 2018; 31-39.

  22. Tomori Y, Ohashi R, Sawaizumi T, Naito Z, Nanno M, Takai S. Intramuscular epithelioid sarcoma presenting as extrinsic flexor tightness in the forearm. JHS. 2018; 43(10): 954.e1-954.e5.

  23. Giacchetti A, Bobyr I, Scarpelli M, Ricotti G. Outcomes of surgical treatment alone in elder patient with classic-type epithelioid sarcoma. Case report. J Dermatol Surg. 2017; 21 (1): 35-38.

  24. Bianchi G, Sambri A, Righi A, Dei-Tos A, Picci P, Donati D. Histology and grading are important prognostic factors in synovial sarcoma. EJSO. 2017; 43 (9): 1733-1739.

  25. Sahoo T. Synovial sarcoma of palmar aspect of hand and survival: a rare case report. JCDR. 2017; 11(7):XD09-XD11.

  26. Ramirez D, Hwang S, Athanasian E, Wang L, Hameed M. Atypical lipomatous tumor of the hand with transformation to dedifferentiated liposarcoma: a case report. Skeletal Radiol. 2017; 47 (5): 703-709.

  27. Wang H, Nie P, Dong C, Li J, Huang Y, Hao D et al. CT and MRI Findings of Soft Tissue Adult Fibrosarcoma in Extremities. Biomed Res. Int. 2018; 2018: 1-7.

  28. Zahid-Hossain AKM, Gazi-Zahirul H, Tossaddeque-Hossain S, Dinesh-Prasad K. Congenital-infantile fibrosarcoma of hand - a case report. SciFed Dent Oral Res J. 2016; 1 (2): 555560.

  29. Georgiev G, Slavchev S, Ananiev J. A rare case of dermatofibrosarcoma protuberans of the thumb in an 80-year-old Woman. Cureus. 2018; 10 (1):e2016.

  30. Shah K, McHugh J, Folpe A, Patel R. Dermatofibrosarcoma protuberans of distal extremities and acral sites. Am J Surg Pathol. 2018; 42 (3): 413-419.

  31. Asuquo M, Nwagbara V, Nnoli M, Ashindoitiang J, Ugbem T, Akpan S. Neurofibrosarcoma: case series in south-south Nigeria. Int J Med. 2017; 5 (1): 79.

  32. Trisal M, Khan S, Mohd-Jaseem H, Jetley S, Husain M. Clear cell sarcoma in an elderly female - A rare case report with literature review. J Diagn Pathol Oncol. 2017; 2 (2): 37-39.



EVIDENCE LEVEL

III Tipo de estudio observacional, descriptivo y transversal.




2020     |     www.medigraphic.com