Hand Tumors

Any abnormal growth or mass on the hand can be considered a Hand Tumor. While normal tissue cells can regulate growth, tumor cells have lost this ability resulting in overgrowth forming a lump or bump. While many people believe that the word tumor is synonymous with cancer, this is just not the case. 95% of all hand tumors are benign when skin malignancies are excluded.

The most common types of Hand Tumors are Ganglion Cyst and giant cell tumors of the tendon sheath. A Ganglion Cyst is a fluid filled mass that is frequently found in the joints of the hand or wrist. Giant cell tendon sheath tumors present as a solid lump on the palmar surface of a finger, and can make it difficult to fully flex the affected digit. While these types of tumors are not cancerous, they can be extremely painful and decrease hand function. All abnormal growths should be examined by a physician.

Since the hand is composed of many different tissue types (bone, skin, fat, tendons, ligaments, blood vessels, nerves, etc.) many different tumor types are possible. The true cause of many tumors is unclear; however trauma is thought to play a role in some. Repetitive motion injuries can cause inflammation leading to abnormal growth of cells. Occasionally skin cells or a foreign body can become trapped within the tissues resulting in tumor growth encapsulating the debris. Over time Arthritis can cause boney growths called bone spurs to form which can be hard and painful.

While most Hand Tumors are benign the likelihood of cancer is a rare but real possibility. Malignancies of the hand are usually cutaneous in origin. Other cancers include the soft tissue tumors and bone tumors.

The symptoms associated with Hand Tumors can vary greatly depending on several factors, such as tissue type, size and location. Most Hand Tumors present as a visible lump or bump on the hand or wrist. They can form gradually over time or appear suddenly on or below the surface of the skin. They may be soft to firm and may or may not move on palpation. Many tumors are painless and go undiagnosed until they actually interfere with hand function or become large in size. Tumors growing near a nerve or on the bone can be extremely painful and so are usually diagnosed earlier. Depending on location a hand tumor may affect joint mobility or may just be aesthetically displeasing.

The physician will require a detailed history including traumatic injuries, occupational hazards and family history. A complete physical examination of the extremity will then be performed. X-rays may be used to determine bone involvement. MRI (magnetic resonance imaging) and ultrasound is used to visualize the soft tissues for abnormalities.

Primary Lymphoma of Capitate (Rare)

Most hand tumors will require surgical excision to completely remove the mass and prevent recurrence. Often this can be accomplished in a short outpatient procedure allowing the client to return home the same day. Once the mass is removed it is sent to a lab for pathology. This is the only way to determine whether the growth is benign or malignant. If non-cancerous, no other treatment (except possibly hand therapy) is required as the lump has already been removed. It is important to discuss all viable options with your physician when a hand tumor is suspected.

Hand tumors can be painful and they may impede the use of the hand. Even if your tumor proves to be benign, Dr. Knight understands the trouble it can be to have this growth on your hand. Dr. Knight will take into account his medical expertise as well as your requirements to craft a treatment plan that fits with your life and schedule.

See Dr. Knight, a hand and wrist surgeon in Dallas and see if he can help you live a more pain free life. Come to our Southlake hand and wrist center or Dallas Fort-Worth friendly office location.

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These are Dr. Knight’s own words from the video. We corrected the anatomy and drug names the automatic captions got wrong and added the punctuation. Nothing he said was changed, added or taken out.

Giant cell tumor excision. This patient had a lengthy history of a mass over the dorsal aspect of the DIP joint. MRI was consistent with a possible epidermal inclusion cyst or a giant cell tumor. You can see here I'm incising the skin over the mass sharply.

Now I'm reflecting the flaps. A small skin hook is placed, and now using scissors I'm carefully dissecting around the margins of the tumor. Consistency visually is that of a giant cell tumor. See, I'm lifting this off of the extensor tendon.

This shelled out nicely. It had one extension going down into the distal interphalangeal joint. See the last bit of tumor that's going out down into the joint.

Now exposing the DIP joint, moving the joint, looking at the articulation, with no further tumor. The pathology was that consistent with a giant cell tumor. As you can see, I'm cutting open the solid mass here.

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These are Dr. Knight’s own words from the video. We corrected the anatomy and drug names the automatic captions got wrong and added the punctuation. Nothing he said was changed, added or taken out.

Subungual lipoma excision. This patient had a long history, had a relatively painless mass that was elevating her nail bed. You can see the deformity there. This shows the MRI with the hypointense lesion scalloping out the distal phalanx.

Now I'm removing the nail plate. That shows a large bulging yellowish mass.

Looking at a mid-axial incision, the incision would likely not allow satisfactory removal of the mass, so the incision was made through the central portion of the nail bed. You can see the bulging fat beneath the nail bed. Using careful micro dissection, the lipoma was teased from the attachments to the undersurface of the nail bed.

You can see, as I remove the mass, that there is quite a concavity within the dorsal surface of the distal phalanx.

Final mass removal, and now exposing, or looking at, the distal phalanx. Now you can see there's quite a bit of redundancy to the expanded nail bed. Now you can see the mass, rather large, measuring, this pathology consistent with benign lipoma.

Due to the expanded nail bed, I felt that this should be, the redundancy should be excised, to allow for a typical nail bed repair. And finally the nail bed was repaired with 6-0 plain gut absorbable suture, knot placement.

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