Benign Hand Tumors (Part I): Cartilaginous and Bone Tumors

Hand ◽  
2020 ◽  
pp. 155894472092292
Author(s):  
Kai-Lou C. Yue ◽  
Jonathan Lans ◽  
René M. Castelein ◽  
David I. Suster ◽  
G. Petur Nielsen ◽  
...  
Keyword(s):  
Bone Tumors ◽  
International Classification Of Diseases ◽  
Benign Tumors ◽  
Recurrence Rates ◽  
Giant Cell Tumors ◽  
Intralesional Curettage ◽  
Bony Tissue ◽  
Benign Bone Tumors ◽  
Pathologic Fractures ◽  
Tumors Of The Hand

Background: Benign tumors of the hand present in a wide array of histological subtypes and compose most of the bony tissue tumors in the hand. This study evaluates the characteristics and treatment of benign bone tumors in light of one institution’s experience. Methods: Histologically confirmed benign tumors of the hand were retrospectively identified using International Classification of Diseases codes from 1992 to 2015. A medical chart review was conducted to collect patient characteristics and tumor epidemiology and treatment. Results: A total of 155 benign bone tumors were identified. The median age of patients at the time of surgery was 39.9 ± 12.8 years. All bone tumors were located in the digits, and most were treated by intralesional curettage (n = 118, 76%). Pathologic fractures occurred in 79 bone tumors (51%). Conclusion: Enchondromas (n = 118, 76%) were the most common bone tumor in this series, whereas giant cell tumors were the most destructive and also had the highest recurrence rate (40%). Awareness of tumor features may help physicians with diagnosis, and awareness of recurrence rates is important when counseling patients.

Novel Unidirectional Porous β-Tricalcium Phosphate Used as a Bone Substitute after Excision of Benign Bone Tumors of the Hand: A Case Series

2018 ◽  
Vol 23 (03) ◽  
pp. 424-429 ◽  
Author(s):  
Akira Ikumi ◽  
Toru Funayama ◽  
Toshinori Tsukanishi ◽  
Hiroshi Noguchi ◽  
Masashi Yamazaki
Keyword(s):  
Bone Formation ◽  
Tricalcium Phosphate ◽  
Bone Substitute ◽  
Bone Tumors ◽  
Animal Studies ◽  
Case Series ◽  
Clinical Results ◽  
Benign Bone Tumors ◽  
Tumors Of The Hand ◽  
Satisfactory Clinical Result

Unidirectional porous β-tricalcium phosphate (UDPTCP; Affinos®, Kuraray, Tokyo, Japan) has been in clinical use since 2015. Animal studies have confirmed the excellent potential of UDPTCP with regard to bone formation and material absorption. We present the first three clinical cases using UDPTCP as a bone substitute after curettage of benign bone tumors of the hand. All three patients were males, 29-, 30- and 81-years-old, two having a diagnosis of enchondroma and the other, a bone ganglion, with a pathological fracture identified in one case. Over a mean follow-up of 10 months, all patients achieved satisfactory clinical result, with no adverse events of UDPTCP noted. Radiographic evidence of good bone formation and material absorption was observable over the postoperative course. UDPTCP provided satisfactory clinical results, with good biocompatibility and fast resorption characteristics. Therefore, UDPTCP could provide a safe and reliable filling substitute for bone defects following curettage of small bone tumors.

Radiologic Evaluation of Bone Incorporation of Strut Allografting in Bone Defects After Curettage of Benign Bone Tumors

1997 ◽  
Vol 01 (02) ◽  
pp. 141-148
Author(s):  
H.-N. Shih ◽  
Y.-J. Chen ◽  
K.-Y. Hsu ◽  
T.-J. Huang ◽  
C.-F. Tan ◽  
...  
Keyword(s):  
Functional Results ◽  
Long Bone ◽  
Bone Cysts ◽  
Giant Cell Tumors ◽  
Intralesional Curettage ◽  
Radiographic Appearance ◽  
Radiologic Evaluation ◽  
Pathologic Fractures ◽  
Aneurysmal Bone Cysts

Large osseous defects have long been a challenge to the reconstructive surgeon. In a series of 104 patients (average age of 26 years; range, 11–60 years) with space occupying lesions of the long bone, we implanted deep-frozen (-70° C) cortical strut allografts into the defects after intralesional curettage. Because of the relatively few published reports on the radiographic appearance of the postoperative course of bone grafting healing, this study was done to investigate the course of radiographic change. This series included 36 fibrous dysplasias, 29 unicameral bone cysts, 22 giant cell tumors, 12 aneurysmal bone cysts, 3 benign fibrous histiocytomas and 2 ossifying fibromas. Fifty-six patients had pathologic fractures. The mean volume of the defect after curettage was 210 ml (range, 56–460 ml). All the patients were followed up for an average of 4 years (range, 2–6 years). At follow-up, good or excellent functional results were found in 97% of the patients (101/104). The radiographs demonstrated complete incorporation of the allogeneic implant and new bone formation in the cavity in 83% of the patients (86/104) (using a semiquantitative method). All pathologic fractures healed. There was no local recurrence or fracture of the cortical graft. There were no other serious complications except for one avascular necrosis of the femoral head. The process of allograft incorporation was similar to that of fresh autograft, though remodeling was rather delayed.

scholarly journals Unique Application of K-Y Jelly in Cryotherapy for Giant Cell Tumors of the Distal Femur - A Case Report

2021 ◽  
pp. 1-7
Keyword(s):  
Case Report ◽  
Distal Femur ◽  
Tissue Architecture ◽  
Recurrence Rates ◽  
Giant Cell Tumors ◽  
Intralesional Curettage ◽  
Appropriate Treatment ◽  
Thermal Conducting ◽  
Aggressive Tumor ◽  
Semi Solid

GCTs are a locally aggressive tumor that can result in significant pain and dysfunction through the disruption of bony and nearby soft tissue architecture. Although generally benign, these tumors have been shown to have 1-9% chance of metastasis and a local recurrence rate of up to 65%. For these reasons, appropriate treatment is essential to remove primary lesions as well as reduce the odds of metastatic disease and lower recurrence rates. Cryosurgery is a welldescribed technique used to achieve local control of primary GCTs. Modern cryoablation utilizes a cryoprobe to freeze surrounding tissues via release of a thermal conducting gas (argonhelium). The optimal technique for eradication of GCT is a widely debated topic rooted in rates of complications and tumor recurrence. Herein, we describe a case report of a 30-year-old female with a large distal femoral GCT that underwent intralesional curettage and adjunctive cryotherapy utilizing K-Y jelly as a semi-solid medium to transmit the freeze zone more evenly within the cavity. Following cryoablation, the cavity was filled with antibiotic loaded polymethyl methacrylate cement. This technique has scarcely been described in the literature and warrants further investigation.

Treatment of Benign Bone Tumors of the Hand Using Demineralized Bone Matrix

2009 ◽  
Vol 123 (6) ◽  
pp. 214e-216e ◽  
Author(s):  
Jeffrey V. Manchio ◽  
Osak O. Omulepu ◽  
Jeffrey Weinzweig
Keyword(s):  
Bone Tumors ◽  
Demineralized Bone Matrix ◽  
Bone Matrix ◽  
Benign Bone Tumors ◽  
Tumors Of The Hand ◽  
Demineralized Bone

Pathologic Fractures of the Proximal Femur Secondary to Benign Bone Tumors

2001 ◽  
Vol 393 ◽  
pp. 279-286 ◽  
Author(s):  
Eugene K. Wai ◽  
Aileen M. Davis ◽  
Anthony Griffin ◽  
Robert S. Bell ◽  
Jay S. Wunder
Keyword(s):  
Proximal Femur ◽  
Bone Tumors ◽  
Benign Bone Tumors ◽  
Pathologic Fractures

scholarly journals Comparison between Benign and Malignant Primary Bone Tumors-A Histopathological Study of 119 Cases

2018 ◽  
Vol 29 (2) ◽  
pp. 74
Author(s):  
Farah Falah Hasan ◽  
Haider Lateef Mohammed
Keyword(s):  
Bone Tumors ◽  
Benign Tumors ◽  
Histopathological Study ◽  
Malignant Bone Tumors ◽  
Female Ratio ◽  
Primary Bone Tumors ◽  
Benign Bone Tumors ◽  
Common Location ◽  
Primary Bone ◽  
The Mean

This is a prospective study done at Al wasity teaching hospital for reconstructive surgeries in Bagdad in a period from November 2014 to April 2017, using a Total of 119 samples of primary bone tumors which were diagnosed both histopathologically and radiologically. The main objectives of this study was to make a comparison between benign and malignant bone tumors. Immunohistochemical staining was done to confirm the diagnosis of primary malignant bone tumors and the proliferative index of them were carefully evaluated. Out of 119 samples of primary bone tumors used in this study ,100 (84%) were benign and borderline(osteoclastoma) and 19(16%) were malignant, the mean age for benign tumors was lower than the mean age for primary malignant one and both frequently present in the 2nd decade of life, male to female ratio for benign bone tumors was 3\2 and 8.5\1 for primary malignant one, femure was the most common location for benign bone tumors while tibia was the most common bone affected by primary malignant bone tumors. the study also showed that the most common benign bone tumors were osteochondromas(67%) and most common primary malignant bone tumors were osteosarcomas(52.63%),thus this study rise a conclusion that in general, primary bone tumors were mainly benign, occurred predominantly in the second decade of life with a male preponderance

scholarly journals Interobserver and Intraobserver Reliability of the Enneking Classification in Plain Radiographic Staging of Benign Bone Tumors of the Extremities in Patients Seen at the Philippine General Hospital

2021 ◽  
Vol 55 (3) ◽  
Author(s):  
Bernardino II Alpuerto ◽  
Edward Wang
Keyword(s):  
Bone Tumors ◽  
Interobserver Reliability ◽  
Intraobserver Reliability ◽  
Benign Tumors ◽  
Kappa Statistics ◽  
Tumor Registry ◽  
Repeat Testing ◽  
Plain Radiographs ◽  
Benign Bone Tumors ◽  
Orthopedic Surgeons

Objective. To determine the interobserver and intraobserver reliabilities of the Enneking Classification system in staging benign bone tumors. Methods. Photographs of traditional plain radiographs of 65 histologically benign tumors from the PGH Department of Orthopedics Tumor Registry were used in the study. Nine Orthopedic surgeons (three consultants, one fellow, and five senior residents) staged the tumors using the Enneking Classification based on radiographic tumor-host margins. The photographs were sent to the surgeons twice (batch 1 and 2), three months apart, for staging. The Fleiss and Cohen kappa statistics were used to determine interobserver and intraobserver reliabilities, respectively. This is a pilot study. Results. There was only fair interobserver reliability of the Enneking Classification staging with Fleiss kappa of 0.38 and 0.26 for batches 1 and 2, respectively. Also, there was only moderate intraobserver reliability (Cohen kappa 0.48) for the staging. Moreover, there was also a relatively low intraobserver percent agreement (67%) among raters. In both reliabilities, the consultants/fellow group consistently showed better interobserver and intraobserver reliabilities compared to the residents. Conclusion. The Enneking Classification in staging benign bone tumors had relatively low interobserver and intraobserver reliabilities. There was also a tendency of experienced orthopedic tumor consultants and senior residents to stage the same radiograph differently upon repeat testing.

scholarly journals Chondromas and multiple enchondromatosis

2021 ◽  
Vol 27 (4) ◽  
pp. 441-445
Author(s):  
P. Lascombes ◽  
◽  
L. Mainard-Simard ◽  
◽  
Keyword(s):  
Surgical Treatment ◽  
Bone Tumors ◽  
Benign Tumor ◽  
Clinical Presentation ◽  
Radiological Findings ◽  
Benign Bone Tumors ◽  
Multiple Enchondromatosis ◽  
Pathologic Fractures ◽  
Bone Deformities

Introduction The chondromas are a cartilaginous proliferation of mature appearance and moderate size, reason why these tumors are regarded more like hamartomas than real benign tumor. Chondromas represent 10 to 12 % of benign bone tumors. Any bone of an enchondral ossification may be involved. Several bones can be involved, and the disease is called “chondromatosis”. In the review we describe clinical and radiological findings of this pathology as well as indications for reconstructive surgery. Material and methods The review is dedicated to isolated chondromas, periosteal and extraskeletal chondromas, chondromatosis. Results The aspects of epidemiology, clinical presentation, radiology, MRI, prognosis, indications and methods of surgical treatment have been described in the article for each types of chondroma and enchondromatosis. Conclusion Chondromas are benign bone tumors which may be responsible of pathologic fractures. Their surgical treatment consists in curettage and bone grafting or bone-cement filling with or without osteosynthesis. Multiple enchondromatosis should be considered as an osteochondrodysplasia. Its treatment is not the treatment of the multiple chondromas themselves, but of the bone deformities and length discrepancy induced by the disorder. The transformation of some tumors in chondrosarcomas in adolescence or adulthood needs a strict follow up of these patients.

CRYOSURGERY IN THE TREATMENT OF PATIENTS WITH BONE TUMORS

2019 ◽  
Vol 65 (2) ◽  
pp. 165-171
Author(s):  
Aleksey Belyaev ◽  
Georgiy Prokhorov ◽  
Anna Arkhitskaya
Keyword(s):  
Liquid Nitrogen ◽  
Bone Tumors ◽  
Cryogenic Treatment ◽  
Long Term Results ◽  
Bone Lesions ◽  
Giant Cell Tumors ◽  
Primary Bone Tumors ◽  
Circulation Circuit ◽  
Recent Emergence ◽  
Primary Bone

A review of the literature shows that surgical procedures will remain the standard treatment for primary bone tumors. Analysis of studies on the assessment of long-term results shows that additional double cryogenic treatment of the curettage cavity can improve the treatment outcomes of patients with giant cell tumors, dysplastic diseases and some forms of malignant lesions. The traditional execution of the procedure is associated with the open installation of liquid nitrogen in the bone cavity, which requires special skills in handling aggressive refrigerant from the staff and does not exclude complications. In case of multiple metastatic bone lesions, surgical treatment is not indicated. The recent emergence in clinical practice of new equipment with a closed liquid nitrogen circulation circuit inside cryoprobes resumes interest in cryoabla-tion of bone tumor lesions using modern minimally invasive puncture cryotechnology and expanding indications for its use in patients with severe comorbidities.

Imaging Features of Primary Tumors of the Hand

2020 ◽  
Vol 16 ◽  
Author(s):  
Filippo Boriani ◽  
Edoardo Raposio ◽  
Costantino Errani
Keyword(s):  
Soft Tissue ◽  
Soft Tissues ◽  
Epithelioid Sarcoma ◽  
Case Series ◽  
Malignant Neoplasm ◽  
Benign Tumors ◽  
Imaging Features ◽  
Primary Tumors ◽  
Therapeutic Decisions ◽  
Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

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