Other Hand Tumours

1.  Foreign Body Granuloma

 

Management

 

Curettage and bone graft (if bony)

Excision of lump 

- recurrence very unusual

 

2.  Osteochondroma

 

Xray

 

Cortical flow evident

 

3.  Brown's tumour

 

Causes

 

Primary hyperparathyroidism

Secondary hyperparathyroidism

- CRF

 

X-ray

 

Lytic lesion

- often seen in distal phalanx

 

4.  Nora's lesion

 

Bizarre parosteal osteochondroma

 

5.  Neurofibroma

 

Not possible to dissect free

- need to excise

- end to end anastomoses

 

6.  Synovial Chondromatosis

 

Diffuse swelling

 

May have calcification

 

7.  Juvenile Aponeurotic Fibroma

 

Benign fibrous tumour 

- occurs in the hands of children and young adults

- no gender predeliction 

- no tendency to involve ulnar digits as with Dupuytren's disease

 

Calcification is distinguishing feature

- locally infiltrative

 

Management

 

Requires wide local excision without sacrifice of function

- local recurrence common

 

Metastatic fibrosarcoma after local recurrence of JAF reported

- careful follow up required

 

8.  Recurring Digital Fibrous Tumor of Childhood

 

Benign fibrous tumour that develops in fingers and toes in infants and children

- distinguished histologically by intracytoplasmic inclusion bodies within proliferating fibroblasts

 

Probable viral aetiology

- usually on several digits and intradermal

- recurrence rate up to 60%

 

Marginal excision if function compromised

 

No malignant potential 

- spontaneous regression described

 

9.  Malignant Tumours

 

Metastasis

- very rare 

- 50% lung cancer

 

Chondrosarcoma

- most common 

- chemo and radio insensitive

- only treatment is surgery

 

Osteosarcoma and Ewings

- quite rare

 

Dermatofibrosarcoma / Epitheloid Sarcoma / Synovial Sarcoma

 

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