Tumours and hand reconstruction

2011 ◽  
Author(s):  
D. Glynn Bolitho
Keyword(s):  
Soft Tissue ◽  
Bone Grafting ◽  
Giant Cell Tumour ◽  
Tendon Sheath ◽  
Surgical Reconstruction ◽  
Radical Excision ◽  
Marginal Excision ◽  
Partial Amputation ◽  
Plastic Surgical Reconstruction ◽  
Work Up

♦ Hand tumours are common♦ The vast majority are benign♦ Soft tissue – commonest Giant cell tumour of tendon sheath. Treatment marginal excision♦ Bone – commonest – Enchondroma. Treatment – leave if incidental or currette +/− bone grafting♦ Malignant – need full work up with detailed clinical examination, investigation, and planning in a multidisciplinary meeting♦ Treatment is wide/radical excision often with partial amputation +/− plastic surgical reconstruction.

scholarly journals Autogenous soft tissue grafting for periodontal and peri‐implant plastic surgical reconstruction

2019 ◽  
Vol 91 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Giovanni Zucchelli ◽  
Lorenzo Tavelli ◽  
Michael K. McGuire ◽  
Giulio Rasperini ◽  
Stephen E. Feinberg ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Reconstruction ◽  
Plastic Surgical Reconstruction

Ghost Protocol: Greatest Healing Opportunity for Soft Tissue, a Treatment Paradigm for Complex Sarcoma Reconstruction

2015 ◽  
Vol 81 (6) ◽  
pp. 557-563
Author(s):  
Edward M. Kobraei ◽  
Kyle R. Eberlin ◽  
Joseph A. Ricci ◽  
Richard G. Reish ◽  
Jonathan M. Winograd ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Practice Patterns ◽  
Late Complications ◽  
Surgical Reconstruction ◽  
Recent Experience ◽  
Poor Patient ◽  
Treatment Paradigm ◽  
Plastic Surgical Reconstruction ◽  
Sarcoma Treatment ◽  
Complex Wounds

Modern sarcoma treatment has created new challenges for plastic surgeons. This study was designed to review the recent experience and practice patterns following complex sarcoma resection at a large sarcoma center. All cases from October 2013 to October 2014 involving rare nonepithelial tumors, a multidisciplinary surgical team, radiation and/or chemotherapy treatments, and plastic surgical reconstruction were included in the analysis. In addition to evaluating clinical outcomes, cases were reviewed to identify factors associated with excellent or poor patient care. Review of these cases formed the basis of the greatest healing opportunity for soft tissue (GHOST) protocol. Our patient population included seven males (64%) and four females (36%). All except one patient was exposed to radiotherapy, chemotherapy, or some combination. Diverse procedures were used for reconstruction. Early complications occurred in two patients (18%), and late complications in four patients (36%). Sarcoma resection was found to be highly morbid in our series. Patients with poor preoperative nutritional status were more likely to experience complications postoperatively. The decision to stage a reconstruction was complex and influenced by several factors. Multimodal sarcoma treatments may involve highly morbid procedures and create complex wounds. The GHOST protocol is a useful reference for plastic surgeons.

scholarly journals Giant cell tumour of tendon sheath mimicking nodal osteoarthritis

2020 ◽  
Vol 13 (2) ◽  
pp. e231902
Author(s):  
Bhavana Pottabatula ◽  
Maryam Sattari
Keyword(s):  
Soft Tissue ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Bone Cyst ◽  
Tendon Sheath ◽  
Definitive Diagnosis ◽  
Cell Tumour ◽  
Soft Tissue Lesion ◽  
Malignant Lesions ◽  
Slow Growing

Giant cell tumour of the tendon sheath (GCTTS) commonly presents as a slow-growing and painless soft-tissue lesion in the hand. It has a propensity to mimick other benign and malignant lesions of the hand including lipoma, haemangioma, myxoid cyst, synovial sarcoma, aneurysmal bone cyst, fibroma and osteosarcoma. GCTTS has a unique histopathological appearance that aids in definitive diagnosis. Although bony invasion and local aggressive characteristics have only been reported rarely, the treatment of choice is local excision. The following case illustrates a fairly typical presentation of GCTTS with certain atypical features.

scholarly journals Giant cell tumour of the tendon sheath of the spine: clinical features and imaging findings

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Piaoe Zeng ◽  
Annan Zhang ◽  
Le Song ◽  
Jianfang Liu ◽  
Huishu Yuan ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Giant Cell ◽  
Facet Joint ◽  
Giant Cell Tumour ◽  
Soft Tissue Mass ◽  
Bone Destruction ◽  
Tendon Sheath ◽  
Imaging Findings ◽  
Tissue Mass ◽  
Pet Ct

Abstract Objectives To review the clinical and imaging data of spinal giant cell tumour of the tendon sheath (GCTTS) to improve our understanding of the disease. Methods The imaging findings, clinicopathological features and clinical outcomes of 14 patients with pathologically confirmed spinal GCTTS were analysed retrospectively. Results All 14 patients had a single spinal lesion, including ten cervical vertebra lesions and four thoracic vertebra lesions. CT scan findings: The lesions showed osteolytic bone destruction and were centred on the facet joint, eroding the surrounding bone with a paravertebral soft tissue mass. MRI scan findings: all the lesions manifested predominantly as isointense or hypointense on T1-weighted imaging (T1WI). On T2-weighted imaging (T2WI), eight lesions were hypointense, and four were isointense. The remaining two lesions showed slight hyperintensity. The enhanced scans of eight lesions showed moderate to marked homogeneous or heterogeneous enhancement. PET/CT findings: Among the five patients who underwent PET/CT, three presented lesions with well-defined, sclerotic borders, and the uptake of 18F-FDG was markedly increased. One lesion showed an ill-defined border and an uneven increase in 18F-FDG uptake with an SUVmax value of 8.9. A recurrent lesion was only found on PET/CT 45 months after surgery and the SUVmax was 5.1. Conclusions Spinal GCTTS is extremely rare. Osteolytic bone destruction in the area of the facet joint with a soft tissue mass and hypointensity on T2WI images are indicative of the spinal GCTTS. GCTTS shows high uptake of 18F-FDG, and PET/CT is helpful in detecting recurrent lesions.

scholarly journals Scaphoid instability caused by a giant cell tumour of the tendon sheath: A case report

2017 ◽  
Vol 46 (3) ◽  
pp. 1263-1270
Author(s):  
Yanjun Wang ◽  
Xiaoxiao Zhu ◽  
Genwang Pei ◽  
Xianshang Zeng ◽  
Deng Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Giant Cell ◽  
External Fixator ◽  
Giant Cell Tumour ◽  
Histopathological Examination ◽  
Tendon Sheath ◽  
Cell Tumour ◽  
Carpal Instability ◽  
Soft Tissue Tumour ◽  
Tissue Tumour

Giant-cell tumour of the tendon sheath (GCTTS) is a soft tissue tumour that may invade bone, causing an intrinsic osseous lesion or instability on radiographs. A case with scaphoid instability caused by a histologically-confirmed neighbouring GCTTS has rarely been described in the literature. No definite and radical method is available for the treatment of GCTTS. This report describes an unusual case of a 22-year-old woman who previously experienced a GCTTS in her right elbow, which was removed 10 years earlier. Currently, she presented with an enlarged painless right wrist mass with focal swelling. The mass has been present for 5 years. During the previous 6 months, she felt something pop and experienced pain with limited motion in her right wrist. Magnetic resonance imaging demonstrated a well-circumscribed soft tissue mass. Under general anaesthesia, complete surgical resection of the mass was undertaken. Histopathological examination revealed that the mass was a GCTTS. Less invasive leverage reduction with external fixator support and iliac crest bone autologous graft for treatment of carpal instability were performed. Radical resection combined with external fixator support and bone grafting can provide a new option for the treatment of carpal instability.

Achilles Tenorrhaphy in Five Dogs: A Modified Surgical Technique and Evaluation of a Cranial Half Cast

1998 ◽  
Vol 11 (04) ◽  
pp. 205-210 ◽  
Author(s):  
H. Burbidge ◽  
E. Firth ◽  
S. Fox ◽  
S. Guerin
Keyword(s):  
Soft Tissue ◽  
Surgical Technique ◽  
Surgical Procedure ◽  
Normal Function ◽  
Surgical Reconstruction ◽  
Bone Apposition ◽  
Cast Material ◽  
Bilateral Lesions ◽  
Bone Tunnels

SummaryAchilles mechanism rupture in four of five dogs was treated with tenorrhaphy using a modified surgical technique designed to optimise accurate apposition of tendon to bone. Two bone tunnels were drilled in the calcaneal tuber from a plantomedial - dorsolateral, and plantolateral – dorsomedial direction respectively. The distal ends of the tendons were sutured to the calcaneal tuber using a Krachow suture pattern. The remaining dog had a mid-tendon Achilles mechanism rupture. A resinous half cast was placed on the cranial aspect of the tarsocrural joint of all five dogs, for a minimum of six weeks, in order to provide limited post operative support. Du e to insufficient cast material two of the support splints failed and one of these cases also required a second surgical procedure. A varying amount of soft tissue irritation was noted in each case. All of the five Achilles mechanisms healed, and all of the dogs returned to normal function.Five dogs with surgical reconstruction of the Achilles mechanism were stabilised postoperatively with a resinous half cast placed on the cranial aspect of the tarsocrural joint for a minimum of six weeks. Two of these casts failed at the tarsocrural joint when six folds of casting material were used; all subsequent cases had eight folds applied. Variable soft tissue irration was observed under the cast in each case. A modified surgical technique using a Krachow suture pattern allowed good tendon-bone apposition. All five Achilles mechanisms healed, and all dogs returned to normal function. Bilateral lesions were identified in 3 of the 4 dogs examined.

LOCAL RECURRENCES AFTER THE TREATMENT OF SOFT TISSUE MALIGNANT FIBROUS HISTIOCYTOMA (UNCLASSIFIEDPLEOMORPHIC SARCOMA) OF THE LIMBS

2019 ◽  
Vol 72 (8) ◽  
pp. 1523-1526
Author(s):  
Oleksandr O. Lytvynenko ◽  
Volodymyr F. Konovalenko ◽  
Anton Yu. Ryzhov
Keyword(s):  
Soft Tissue ◽  
Malignant Fibrous Histiocytoma ◽  
Fibrous Histiocytoma ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
Primary Treatment ◽  
Radical Excision ◽  
Local Recurrences ◽  
Results Of Treatment

Introduction: The treatment of patients with malignant fibrous histiocytoma as well as other soft tissue sarcomas is not sufficiently effective up to date, and has largely changed and reflects the alterations, occurred in oncology as a whole. The number of amputation decreased over the last 10-15 years. Some researchers associate the improvement of treatment outcomes with the development of combined and complex methods. The aim of the study is an improvement of the results of treatment of patients with soft tissue malignant histiocytoma on the basis of determination of factors, influencing local recurrence development. Materials and methods: The basis of our study was a comprehensive analysis of examination and treatment results of 130 patients with MFH of the soft tissue of limbs, of them in 84 patients (64.6%) the recurrences developed. The group included 45 (53.6%) males and 39 (46.4%) females. The major part of patients – 82.1% (60 patients) were older than 40 years. Results and conclusions: The number of recurrences after the treatment in general surgical facilities is 86.9%, whereas in the patients after the treatment in the specialized oncological facilities this figure is twice lower (40%). The characteristic of the medical facility where the patient receives his/her primary treatment largely affects the development of local recurrences, patients’ quality of life and overall survival rates. The surgical method remains the leading modality in the treatment of MFH of ST. Wide and radical excision of tumors in the specialized oncological facilities allows achieving better survival outcomes of the patients.

A Case Study of a Large and Rare Pleomorphic Liposarcoma in The Chest Area

2020 ◽  
Author(s):  
Yuanjun Cheng
Keyword(s):  
Delayed Diagnosis ◽  
Clinical Work ◽  
Radical Excision ◽  
Pathological Findings ◽  
Chest Tightness ◽  
Pleomorphic Liposarcoma ◽  
Left Chest ◽  
Specific Symptoms ◽  
Work Up

Pleomorphic liposarcoma rarely develops in the chest area. This report presents a primary pleomorphic liposarcoma that was discovered in the left chest area of a 74-year-old female patient. The patient had presented specific symptoms, including cough, chest tightness and shortness of breath. A radical excision of the tumor was performed. The tumor was extremely large (27 cm - 24 cm- 10 cm) and completely encapsulated. Upon histological examination, it was diagnosed as a giant, pleomorphic liposarcoma. Thereafter, non-specific radiological and endoscopic results during clinical work-up delayed diagnosis until post-operative histology were gathered. In this report, the case-specific clinical and radiological diagnostic challenges are discussed, as well as the relevant surgical and pathological findings.

scholarly journals AB0049 Rheumatoid arthritis and giant cell tumour of the tendon sheath: A case report

2001 ◽  
Author(s):  
S Kiraz ◽  
D Altýnok ◽  
Ý Ertenli ◽  
MA Öztürk ◽  
S Apras ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Case Report ◽  
Giant Cell ◽  
Giant Cell Tumour ◽  
Tendon Sheath ◽  
Cell Tumour

Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

2021 ◽  
pp. 105566562110076
Author(s):  
Maria Costanza Meazzini ◽  
Noah Cohen ◽  
Valeria Marinella Augusta Battista ◽  
Cristina Incorvati ◽  
Federico Biglioli ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Surgical Procedures ◽  
Efficient Method ◽  
Bone Grafting ◽  
Cleft Lip ◽  
Soft Tissues ◽  
Cleft Lip And Palate ◽  
Face Mask ◽  
Younger Patients ◽  
Good Healing

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

Sign in / Sign up

Export Citation Format

Share Document