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TUMOURS AND TUMOROUS CONDITIONS OF THE HAND
Prepared by:Dr.mohamed Abd alhussein LaftahBAGHDAD UNIVERSITYALKINDY COLLEGE OF MEDICINEAlwasity teaching hospital
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Hand tumors arise from any tissue—skin, subcutaneous tissue,tendons, nerve, blood vessels, and bone.
Hand tumour can be classified in many different ways which may cause confusion between types and their management plan.
This lecture mainly concerned about how to classify them in simple and accurate way.
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Benign tumors account for 95% of hand masses if skin cancers are excluded.
Ganglions represent 60 to 70% of hand tumors, followed in frequency by inclusion cysts, warts, (verruca vulgaris),giant cell tumors of tendon sheaths, foreign body granulomas,lipomas and hemangiomas.
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Hand tumour can be classified into major 3 type:
1. Benign tumors.2. Malignant tumors .3. Tumorous conditions .
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Each of benign and malignant type can further be classified according to tissue of origin into:
1. Bone tumour.2. Soft tissue tumour.3. Skin tumour.
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Benign tumours1. Bone tumours:Enchondromas OsteochondromasOsteoid oseoma.Benign osteoblastoma Aneurysmal bone cyst Giant cell tumors of bone Synovial chondromatosis .OsteophyteChondromixoidfibroma
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Enchondromthe most common primary hand bone tumor,occurs chiefly in the 3rd and 4th decades It occurs most commonly in the phalanges, usually in the proximal phalanx
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Osteochondroma
consists of a bony prominence at the level of the metaphysis covered by a cartilaginous cap.
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Osteoid osteoma is an unusual hand tumor occur in phalanges, metacarpals,and carpal bones, and presents in the 2nd and 3rd decades of life with aching pain that is greatest at night. classically relieved by aspirin
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Giant cell tumors of bone
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Aneurysmal bone cyst
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Synovial chondromatosis .
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Osteophyte
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Chondromixoid fibroma
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2.Soft tissue tumours: Muscl : leiomyoma. Tendon: fibroma of tendon sheath.Giant cell tumor of tendon sheath
(xanthoma of the tendon Sheath).Xanthoma Tuberosum
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leiomyoma
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fibroma of tendon sheath
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Giant cell tumor of tendon sheath
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Xanthoma Tuberosum
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Fibrous tumour:FibromaDermato fibroma (fibrous
histiocytoma)Nodular fasciaitis.Firomatosis. Juvenile Aponeurotic Fibroma Infantile digital fibroma.
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Juvenile Aponeurotic Fibroma
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Fibroma
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Dermato fibroma
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Nodular fasciaitis
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Firomatosis.
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Infantile digital fibromatosis
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Adipose tissue tumour:Lipoma. Infiltrating lipomas. Lipoblastomas. Intraneural lipofibromas.
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Lipoma
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Tumors of Peripheral Nerves: Neurofibroma. Schwannoma. Granular Cell Tumor. Neurothekeoma (pacinian neurofibroma). INTRANEURAL TUMORS OF NONNEURAL
ORIGINNumerous nonneural tumors have been reported
in peripheral nerves: lipomas, lipofibromatous hamartomas, and hemangiomas.
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Neurofibroma
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Schwannoma
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Granular Cell Tumor
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Neurothekeoma median nerve
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Vascular Tumors:Hemangioma . Vascular malformation .Lymphangioma .Post traumatic vascular lesion:Traumatic fistulasAtherosclerotic aneurysms.Pyogenic granuloma.Glomus Tumor
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Hemangioma
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Vascular malformation
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Lymphangioma
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Pyogenic granuloma
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Glomus Tumor
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Skin
Benign tumour of skin can be classified according to structure of origin in the skin:
epidermal layer:verruca vulgaris(wart).Keratosis:seborrheac,actinic,solar,irra
diation.ProkeratosisCutaneous HornsKeratoacanthoma
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verruca vulgaris(wart).
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Keratosis:
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Cutaneous Horns
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Keratoacanthoma
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Tumors of epidermal appendages Pilomatricoma(calcifying epithelioma
of Malherbe) Eccrine poroma . Eccrine Spiradenoma.
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Eccrine poroma
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Eccrine Spiradenoma
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Pilomatricoma
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fibrous dermis:Pigmented NeviBlue NeviDermatofibroma
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Pigmented Nevi
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Blue Nevi
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Malignant hand tumours
Bone :Osteogenic Sarcoma.Chondrosarcoma.Ewing Sarcoma.Bone Tumors of the Hemopoietic
System e.g. Malignant lymphomasMetastatic lesion
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Osteogenic Sarcoma
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Chondrosarcoma.
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Ewing Sarcoma
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Metastatic lesion
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Hand Soft tissue malignancy Its mainly sarcoma: Clear cell sarcoma Dermatofibrosarcoma protuberance. Extra abdominal desmoid. Epithelioid sarcoma. Fibrosarcoma. Kaposi sarcoma. Malignant fibrous histiocytoma. Rhabdomyosarcoma. Synovial sarcoma. Acralmyxoinflammatory sarcoma. Fibroblastic sarcoma. Myofibrosarcoma.Mlignant neural tissue: Neurosarcoma Malignant schwannoma.
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Dermatofibrosarcoma protuberance.
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Epithelioid sarcoma
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Fibrosarcoma.
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Skin malignancy
Basal cell carcinomaSquamous cell carcinoma.Malignant melanoma.Sweat gland carcinoma.
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Sweat gland carcinoma
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Tumorous conditions
Its usually not true tumour we can subdivide them to :
1. Cystic leision: Ganglion cyst. Epidermoid cyst (inclusion cyst) . Sebaceous cyst
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Ganglion cyst
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DIP Ganglions
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Epidermoid cyst (inclusion cyst)
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Sebaceous cyst
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2.Non cystic leision:Foreign body reaction.Gouty leisionCutaneous Horns Infection: Viral: e.g. wart Bacterial. Fungal.
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Foreign body reaction.
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The biggest hand in the world
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Thank you