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40 Cards in this Set
- Front
- Back
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What is the most common primary tumor of bone in the hand? |
Enchondroma
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What are the typical radiographic features of an enchondroma?
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A scalloped lytic lesion
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What conditions are associated with enchondromas?
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Ollier Disease (multiple enchondromas) and Maffucci syndrome (mult enchondromas associated with subcutaneous hemangiomas
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What is the management of enchondromas?
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Curettage of lesion. May require bone grafting.
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What are the typical presenting symptoms of an enchondroma?
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Usually asymptomatic, incidental finding on X-ray. May present as a pathologic fracture.
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In what disease do you find an increase in the risk of malignant transformation of an enchondroma to a chondrosarcoma
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Ollier's disease
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Conditions associated with Ollier's disease include . . .
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Multiple enchondromas, axial skeletal deformities, increased transformation of enchondromas to malignant chondrosarcomas
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What is the most frequent malignancy of the hand?
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Squamous cell carcinoma
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How do you treat squamous cell carcinoma of the thumb?
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Amputation of thumb at IP joint. Selective lymph node sampling may be beneficial.
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What is a glomus tumor?
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Benign hamartoma of neuromyoarterial receptors
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What is the typical location of a glomus tumor?
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Subungual
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What are the symptoms typically associated with glomus tumors
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Exquisite pain, pinpoint tenderness, and cold intolerance
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How do you diagnose a glomus tumor?
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MRI, H&P
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How are glomus tumors treated?
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Simple excision - removal of nail plate. If subungual, make a longitudinal incision in nail plate.
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What is the recurrence rate of glomus tumors after excision?
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20%
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On which surface of the hand do epidermal inclusion cysts occur?
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palmar
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What is the treatment for epidermal inclusion cysts?
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excision
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What are epidermal inclusion cysts?
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Mobile, non-tender masses formed after trauma
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What are the typical radiographic findings of a mucous cyst?
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osteoarthritis with osteophytes
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What is the treatment for a mucous cyst?
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excision of the cyst and osteophyte
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What physical findings are associated with mucous cysts?
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Swelling and nail deformities (nail grooving and skin thinning) +/- pain.
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What is the 2nd most common tumor of the hand?
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Giant cell tumor of tendon sheath (pigmented villonodular tenosynovitis)
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What physical findings are associated with giant cell tumors of the tendon sheath?
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firm, indolent, painless volar mass on the surface of the finger or hand
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What is the treatment for giant cell tumors of the tendon sheath?
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Ray resection or en bloc removal combined with bone grafting
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What is the local recurrence rate of giant cell tumors of the tendon sheath after total surgical excision?
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50%
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What hand tumor starts as a red papule that expands?
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keratoacanthoma
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Keratoacanthoma is a variant of what malignancy?
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Squamous cell carcinoma
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What is the treatment of keratoacanthoma?
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Excisional biopsy
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What hand tumor is associated with immunosuppressed patients?
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keratoacanthoma
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What is the most common benign tumor of the hand?
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Ganglion cyst
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How do you treat ganglion cysts of DIP?
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Debride osteophyte, not ganglion.
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What are the radiographic findings of a chondromyxoid fibroma?
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Radiolucent lesion with small sclerotic rims
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What is the most common solitary hand tumor of neural cell origin?
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Neurilemmoma
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What is the most common source of metastatic tumors to the hand?
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Bronchogenic carcinoma of the lung
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What hand tumor presents with pain at night that is relieved by NSAIDs?
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osteoid osteoma
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Osteoid osteoms typically occur in what age group?
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under 40
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What are the radiographic findings associated with osteoid osteomas?
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Radiolucent zone with dense nidus surrounded by a distinctive area of cortical sclerosis
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What is the treatment of osteoid osteomas?
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Complete excision
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Whatmors is the inheritance pattern of osteochondromas?
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Autosomal dominant
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What is the treatment for osteochondromas?
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Resection of all tumors with reconstructive surgery to repair any bone or joint malalignment
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