gms | German Medical Science

Introduction: The bone and soft tissue tumors that occurred in the hand may be troubled with deciding whether to send to the facility specializing bone and soft tissue tumors or hand surgery. Our hospital has doctors specializing in bone and soft tissue tumors and hand surgery, so there are many opportunities to treat tumors and tumorous lesions that occurred in the hand. Characteristics of the lesion, results of treatment and so on will be examined.

Patients and Method: Of the 837 bone and soft tissue tumors who underwent surgical treatment at our hospital during the 10 years from 2008 to 2017, 168 tumors in the hand of 160 cases that occurred beyond the wrist joint were examined. We analyzed the site of occurrence, pathological diagnosis, local recurrence, complications.

Results: The age was 1 to 83 years old, and the average was 54.0 years old. There were 69 males and 99 females. The right hand was 80 and the left was 88. The site of occurrence was a wrist joint 6, a palm 55, a hand dorsal 9, and a unique finger part 98. Malignancy was only one case of finger nerve metastasis of malignant melanoma, other than that were benign (99.4%). The postoperative observation period was 17.4 months on average. Pathological diagnosis is most frequent in GCTTS 36, ganglion 35, fibromatosis 22, epidermal cyst 16, hemangioma 19, Schwannoma 8, glomus tumor 6, fibroma of tendon sheath 6, angioleiomyoma 3, myopericytoma 2, fibroma 2, venous thrombosis 2, and 1 in other cases. Local recurrence was in 4 cases, GCTTS was 3 cases, and epidermal cyst was 1. Postoperative complications occurred in 3 cases with sensory decline and 2 cases with limited joint range of motion.

Discussion: In the various reports, the occurrence frequency of soft tissue tumors in the hand region is most frequent, in the order of ganglion, GCTTS, epidermal cyst, lipoma, but in our series GCTTS was the most frequent. This is limited to the cases in which surgery was performed, and it was inferred that there were many cases that did not performed surgery at the time of diagnosing as ganglion. Recurrence occurred in 3 cases in GCTTS, and it was considered that GCTTS tends to invasively expand within joints, bones, and tendon sheaths, so recurrence was occurred. Three patients with postoperative sensory decline appeared. They were 2 Schwannomas and 1 GCTTS. Treating GCTTS, we must pay attention to a possibility that postoperative sensation decline may appear even after microscopic operations.