Bogumill G P, Sullivan D J, Baker G I
Clin Orthop Relat Res. 1975 May(108):214-22. doi: 10.1097/00003086-197505000-00035.
A review of 129 hand tumors suggests that diagnosis of a swelling in the hand is often uncertain because of the close proximity of many different tissues in a small volume. Histologic diagnosis is necessary to assure appropriate treatment; excisional biopsy should be done whenever possible; if the lesion is benign, treatment has been completed; in the event the lesion is malignant, further treatment will not have been materially compromised. The margin of normal tissue around malignant lesions often precludes treatment of such tumors of the hand by ray resection or wide local excision because adequate wide excision will frequently leave nothing functional. Attempts at wide local excision are ofter compromised by the surgeon's natural desire to preserve function; this frequently results in incomplete removal of the tumor. The function preserved will be of little benefit to a patient with widespread metastases.
一项对129例手部肿瘤的回顾研究表明,由于手部狭小空间内多种不同组织相邻,手部肿胀的诊断往往并不确定。组织学诊断对于确保恰当治疗很有必要;只要有可能就应进行切除活检;如果病变是良性的,治疗即告完成;万一病变是恶性的,进一步治疗也不会受到实质性影响。恶性病变周围的正常组织边缘常常使得无法通过射线切除或广泛局部切除来治疗手部此类肿瘤,因为充分的广泛切除常常会导致手部无功能。广泛局部切除的尝试常常因外科医生保留功能的自然愿望而受到影响;这常常导致肿瘤切除不完全。对于已有广泛转移的患者而言,保留的功能几乎没有益处。