1/23. Soft-tissue angioleiomyoma of the hand as a rare differential diagnosis of haemophilic pseudotumour.The benign vascular tumours known as angioleiomyomas, which originate from smooth muscle cells of arterial or venous walls are rare, particularly in the region of the hand. Frequently, the diagnosis is only made after surgical extirpation and histological assessment. The occurrence of an angioleiomyoma in a haemophiliac has not yet been reported, to our knowledge. A 62-year-old patient with a haemophilia B complained of increasing pain in the vicinity of the soft tissue covering the carpo-metacarpophalangeal joint of his left palm. In the T1-weighted magnetic resonance images a hypointense well-demarcated mass was found, showing a homogeneous enhancement after intravenous application of contrast medium. T2-weighted images showed a hyperintense signal. Based on clinical and radiographic findings, the tumour was initially thought to be a haemophilic pseudotumour arising from a prior local haematoma. Intraoperatively, the mass was found to be solid, and histological assessment diagnosed an angioleiomyoma, without signs of malignant transformation. Descriptions of the clinical symptoms of angioleiomyoma in an extremity vary considerably in the literature. Although rare, the vascular leiomyoma should therefore be contemplated in the differential diagnosis in patients with a solid nodular lesion of unclear aetiology in arms or legs. Especially in a haemophiliac patient, the growth can easily be mistaken for a pseudotumour because of its clinical and radiological similarities.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
2/23. Metastatic melanoma in a patient with Clouston syndrome successfully treated with isolated hyperthermic limb perfusion.BACKGROUND: Clouston syndrome is an autosomal dominant disorder characterized by nail dystrophy, partial or total alopecia, and hyperkeratosis of the palms and soles. OBJECTIVE: Although a variety of unusual cutaneous manifestations have been described, the incidence of melanoma in this population is unknown. methods: This article reports a case of in-transit metastatic subungual melanoma in a patient with Clouston syndrome successfully treated with hyperthermic limb perfusion with melphalan. RESULTS: Six months postperfusion, the patient is doing well, with resolution of the extremity erythema and edema. Followup ultrasonography revealed reduction in size of the eight subcutaneous nodules, with the largest measuring 3.3 cm in maximum diameter, representing nearly a 50% reduction in tumor volume postperfusion. CONCLUSION: Although melanoma has also been associated with some forms of ectodermal dysplasia, such as ectrodactyly--ectodermal dysplasia--clefting (EEC) syndrome, the incidence of melanoma in patients with Clouston syndrome is unknown. Thus far, to our knowledge, this is the first case report of melanoma arising in a patient with Clouston syndrome.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
3/23. Cutaneous sclerosing perineurioma of the digits: an uncommon soft-tissue neoplasm. Report of two cases with immunohistochemical analysis.BACKGROUND: Cutaneous sclerosing perineurioma is a recently characterized, uncommon tumor composed of perineurial cells, which exhibits immunoreactivity for epithelial membrane antigen (EMA). These lesions occur preferentially in children and young adults and usually develop as dermal or subcutaneous nodules in the hands or palms. methods: We report two cases of cutaneous sclerosing perineurioma in young patients without stigmata of neurofibromatosis. Histologically, these lesions were well-circumscribed masses and were characterized by a variable number of epithelioid and spindle cells with wavy nuclei end elongated cytoplasmic processes embedded in a dense collagen stroma. RESULTS: These cells showed focal whorling formation, demonstrated robust immunoreactivity for EMA and CD99, and were uniformly negative for S-100 protein, actin (HHF-35), CD34, cytokeratin AE1-3, and CD57. CONCLUSION: We comment on the differential diagnosis of fibrous cutaneous lesions based on immunohistochemistry.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
4/23. Glomangioma arising from the superficial palmar arch in the hand: case report.A patient presented with a glomangioma that presented as an aneurysm of the superficial palmar arch. Throbbing pain, tenderness over the tumor, and cold intolerance were clinical features. Cold intolerance was the major problem. The pathologic diagnosis was glomangioma. Excision of the tumor provided a good result and there has been no recurrence.- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |
5/23. Arthroscopic excision of juxta-articular giant-cell tumor arising from the patellar tendon sheath.Most giant-cell tumors of the tendon sheath are found on the flexor surface of the hand, in the fingers, wrist, or palm. The isolated discrete lesion involving tendon sheaths (localized giant-cell tumor of the tendon sheath) is rarely located intra-articularly, especially in the knee joint. To the best of my knowledge, this is the first reported case of a large, localized, juxta-articular giant-cell tumor of the patellar tendon sheath that was treated successfully with arthroscopic excision.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
6/23. Chondrolipoma in the palm of a child: sonographic and MR findings.Chondrolipoma is a rare form of benign mesenchymoma. We report the case of a chondrolipoma in the palm of a 9-year-old boy with corresponding sonographic, magnetic resonance (MR) and pathological findings.- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |
7/23. Chondrolipoma of the hand: a case report.The authors present the case of a chondrolipoma which was excised from the left hand's palm of an 83-year old woman. Chondrolipomas are rare neoplasms; their terminology and pathogenesis have been controversial in the past. Chondrolipoma in the hand does not seem to have been reported so far. The present case thus expands the spectrum of neoplasms known to arise at this anatomical site.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
8/23. Arterialized venous flow-through flap for simultaneous reconstruction of a radial artery defect and palmar forearm soft-tissue loss from sarcoma resection.A 50-year-old right-handed male presented with a previously incompletely excised low-grade fibrous histiocytoma on his distal radial palmar forearm. Reoperative wide resection resulted in a segmental defect of the radial artery and a large soft-tissue defect with exposed tendons denuded of paratenon. An arterialized venous fasciocutaneous flow-through flap, measuring 8 x 3 cm, was harvested from the dorsal ipsilateral hand and used to reconstruct both the soft-tissue and the segmental radial-artery defects. A full-thickness skin graft was harvested from the ipsilateral groin to cover the dorsal hand wound. Moderate venous congestion was noted in the flap on postoperative day 1 and treated with four days of leeches. Approximately 10 percent of the flap was lost due to the venous congestion. The flap healed well without further complications. At 33 months the flap remained well-perfused, with excellent flow through the reconstructed radial artery evidenced by both clinical examination and by color vascular Doppler exam. The patient had full range of motion in his right hand despite initial postoperative stiffness and reported no cold intolerance in the right hand. There has been no local recurrence of the sarcoma. The authors believe that this is the largest arterialized venous flow-through flap currently reported to have survived, as well as the first reported case of its use for the simultaneous reconstruction of a radial artery defect and an associated soft-tissue loss.- - - - - - - - - - ranking = 5keywords = palm (Clic here for more details about this article) |
9/23. Infantile lipofibromatosis of the upper limb.The imaging features of extensive lipofibromatosis presenting in a 1-day-old female infant are reported. This lesion involved her entire right upper limb, extending from the axilla to the palm of the hand. Radiographs showed marked deformity and thinning of all the right upper-limb bones due to pressure effect of soft-tissue enlargement, especially affecting the distal humerus and proximal forearm bones. magnetic resonance imaging showed a huge soft-tissue mass infiltrating most of the muscles of the entire upper limb, with bony erosion. The mass was largely T1-isointense, moderately T2-hyperintense and showed marked enhancement. There were intra-lesional signal changes consistent with fatty elements. A lesion debulking procedure was performed and the histology was that of lipofibromatosis. The limb was found to be non-viable after the procedure and a subsequent above-elbow amputation was performed. Although the resection margins were not clear, she had no further recurrence over a subsequent 3-year follow-up period.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
10/23. Soft-tissue osteoma of the hand: case report.A soft-tissue osteoma is rare. Only 1 previous case involving the hand has been published. We report a 66-year-old man with a soft-tissue osteoma of the palm that was treated by marginal excision.- - - - - - - - - - ranking = 1keywords = palm (Clic here for more details about this article) |
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