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Tumors of the Hand and Wrist

ganglion of the tendon sheath

Chondrosarcoma  
Enchondroma Glomus Tumor
Epidermal Inclusion Cyst Osteosarcoma
Ganglion Sarcoma
Giant Cell Tumor of Bone Synovial cell sarcoma
Giant Cell Tumor of the Tendon Shealth  

Giant Cell Tumor of the Tendon Shealth

  • Generally 3-5 decades
  • DIP joint most common
  • Firm, tender nodule
  • Treatment: marginal surgical excision. High recurrence rate.

Giant Cell Tumor of Bone

  • Affects epiphysis: distal radius, metacarpal head.
  • Rare instances of metastases.
  • High recurrence rate
  • Xray: expansile, lytic lesion with indistinct borders.
  • Treatment: curretage with bone grafting. Consider polymethacrylate cementation, cryosurgery, cauterization. May require en bloc resection +/- allograft reconstruction / wrist fusion.

Glomus Tumor

  • Generally occurs in subungal location.
  • Generally c/o hypersensitivity of temperature and exquisite pinpoint tenderness with pain that radiates proximally
  • Treatment: Excision. High recurrence rate.

Epidermal Inclusion Cyst

  • Generally result from penetrating trauma, trapping epithelial cells in the subcutaneous tissues.
  • Firm, mobile, painless.
  • Treatment: margninal excision.

 

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