short note on Tumors and tumorous conditions of the hand

1. TUMOURS AND TUMOROUS
CONDITIONS OF THE HAND
Prepared by:
Dr.mohamed Abd alhussein Laftah
BAGHDAD UNIVERSITY
ALKINDYCOLLEGEOF MEDICINE
Alwasity teaching hospital

2.  Hand tumors arise from any tissue—skin,
subcutaneous tissue,tendons, nerve, blood
vessels, and bone.
 Hand tumour can be classified in many
different ways which may cause confusion
between types and their management plan.
 This lecture mainly concerned about how to
classify them in simple and accurate way.

3.  Benign tumors account for 95% of hand
masses if skin cancers are excluded.
 Ganglions represent 60 to 70% of hand
tumors, followed in frequency by inclusion
cysts, warts, (verruca vulgaris),giant cell
tumors of tendon sheaths, foreign body
granulomas,lipomas and hemangiomas.

4.  Hand tumour can be classified into major 3
type:
1. Benign tumors.
2. Malignant tumors .
3. Tumorous conditions .

5.  Each of benign and malignant type can
further be classified according to tissue of
origin into:
1. Bone tumour.
2. Soft tissue tumour.
3. Skin tumour.

6. Benign tumours
1. Bone tumours:
 Enchondromas
 Osteochondromas
 Osteoid oseoma.
 Benign osteoblastoma
 Aneurysmal bone cyst
 Giant cell tumors of bone
 Synovial chondromatosis .
 Osteophyte
 Chondromixoidfibroma

7. Enchondrom
the most common primary hand bone tumor,occurs
chiefly in the 3rd and 4th decades It occurs most
commonly in the phalanges, usually in the proximal
phalanx

8. Osteochondroma
consists of a bony prominence at the level of the
metaphysis covered by a cartilaginous cap.

9. Osteoid osteoma
is an unusual hand tumor occur in phalanges, metacarpals,and
carpal bones, and presents in the 2nd and 3rd decades of life
with aching pain that is greatest at night. classically relieved by
aspirin

10. Giant cell tumors of bone

11. Aneurysmal bone cyst

12. Synovial chondromatosis .

13. Osteophyte

14. Chondromixoid fibroma

15. 2.Soft tissue tumours:
 Muscl :
 leiomyoma.
 Tendon:
 fibroma of tendon sheath.
 Giant cell tumor of tendon sheath (xanthoma
of the tendon Sheath).
 XanthomaTuberosum

16. leiomyoma

17. fibroma of tendon sheath

18. Giant cell tumor of tendon sheath

19. Xanthoma Tuberosum

20.  Fibrous tumour:
 Fibroma
 Dermato fibroma (fibrous histiocytoma)
 Nodular fasciaitis.
 Firomatosis.
 Juvenile Aponeurotic Fibroma
 Infantile digital fibroma.

21. Juvenile Aponeurotic Fibroma

22. Fibroma

23. Dermato fibroma

24. Nodular fasciaitis

25. Firomatosis.

26. Infantile digital fibromatosis

27.  Adipose tissue tumour:
 Lipoma.
 Infiltrating lipomas.
 Lipoblastomas.
 Intraneural lipofibromas.

28. Lipoma

29.  Tumors of Peripheral Nerves:
 Neurofibroma.
 Schwannoma.
 Granular CellTumor.
 Neurothekeoma (pacinian neurofibroma).
 INTRANEURALTUMORS OF NONNEURAL
ORIGIN
Numerous nonneural tumors have been reported in
peripheral nerves: lipomas, lipofibromatous
hamartomas, and hemangiomas.

30. Neurofibroma

31. Schwannoma

32. Granular Cell Tumor

33. Neurothekeoma median nerve

34.  VascularTumors:
 Hemangioma .
 Vascular malformation .
 Lymphangioma .
 Post traumatic vascular lesion:
Traumatic fistulas
Atherosclerotic aneurysms.
 Pyogenic granuloma.
 GlomusTumor

35. Hemangioma

36. Vascular malformation

37. Lymphangioma

38. Pyogenic granuloma

39. Glomus Tumor

40. Skin
Benign tumour of skin can be classified
according to structure of origin in the skin:
 epidermal layer:
 verruca vulgaris(wart).
 Keratosis:seborrheac,actinic,solar,irradiati
on.
 Prokeratosis
 Cutaneous Horns
 Keratoacanthoma

41. verruca vulgaris(wart).

42. Keratosis:

43. Cutaneous Horns

44. Keratoacanthoma

45.  Tumors of epidermal appendages
 Pilomatricoma(calcifying epithelioma of
Malherbe)
 Eccrine poroma .
 Eccrine Spiradenoma.

46. Eccrine poroma

47. Eccrine Spiradenoma

48. Pilomatricoma

49.  fibrous dermis:
 Pigmented Nevi
 Blue Nevi
 Dermatofibroma

50. Pigmented Nevi

51. Blue Nevi

52. Malignant hand tumours
 Bone :
 Osteogenic Sarcoma.
 Chondrosarcoma.
 Ewing Sarcoma.
 BoneTumors of the Hemopoietic System
e.g. Malignant lymphomas
 Metastatic lesion

53. Osteogenic Sarcoma

54. Chondrosarcoma.

55. Ewing Sarcoma

56. Metastatic lesion

57. Hand Soft tissue malignancy
Its mainly sarcoma:
 Clear cell sarcoma
 Dermatofibrosarcoma protuberance.
 Extra abdominal desmoid.
 Epithelioid sarcoma.
 Fibrosarcoma.
 Kaposi sarcoma.
 Malignant fibrous histiocytoma.
 Rhabdomyosarcoma.
 Synovial sarcoma.
 Acralmyxoinflammatory sarcoma.
 Fibroblastic sarcoma.
 Myofibrosarcoma.
Mlignant neural tissue:
 Neurosarcoma
 Malignant schwannoma.

58. Dermatofibrosarcoma
protuberance.

59. Epithelioid sarcoma

60. Fibrosarcoma.

61. Skin malignancy
 Basal cell carcinoma
 Squamous cell carcinoma.
 Malignant melanoma.
 Sweat gland carcinoma.

62. Sweat gland carcinoma

63. Tumorous conditions
Its usually not true tumour we can subdivide
them to :
1. Cystic leision:
 Ganglion cyst.
 Epidermoid cyst (inclusion cyst) .
 Sebaceous cyst

64. Ganglion cyst

65. DIP Ganglions

66. Epidermoid cyst (inclusion cyst)

67. Sebaceous cyst

68. 2.Non cystic leision:
 Foreign body reaction.
 Gouty leision
 Cutaneous Horns
 Infection:
 Viral: e.g. wart
 Bacterial.
 Fungal.

69. Foreign body reaction.

70. The biggest hand in the world

71. Thank you