Gosk Jerzy, Gutkowska Olga, Urban Maciej, Martynkiewicz Jacek, Bąk Michał, Ziółkowski Piotr
Department of Traumatology, Clinic of Traumatology and Hand Surgery, Wroclaw Medical University, ul. Borowska 213, 50-556, Wrocław, Poland.
Department of Pathomorphology, Division of Pathomorphology, Wroclaw Medical University, ul. K. Marcinkowskiego 1, 50-368, Wrocław, Poland.
Arch Orthop Trauma Surg. 2015 Dec;135(12):1763-9. doi: 10.1007/s00402-015-2327-2. Epub 2015 Sep 21.
Hand tumours of neural origin are rare in clinical practice. The aim of this work is to present our experience in operative treatment of benign nerve tumours located in the hand. Special emphasis has been put on determining the occurrence rates of particular tumour types characterized by their unique histopathological patterns and describing detailed location of the lesions. The obtained results of treatment were assessed.
The study comprised of 26 patients, both female (19) and male (7). The mean age and age range of the female and male patients were 44.8 years (range, 21-73 years) and 39.6 years (range, 21-74 years), respectively. The patients underwent operative treatment for tumours of neurogenic origin located in the hand between the years 1990 and 2013. In total, 31 tumours in 26 patients were removed. The most common site of tumour origin was small cutaneous branches and only exceptionally the tumours arose from common digital nerves (2 patients). No patient was lost to postoperative follow-up. The shortest period of postoperative follow-up covered 1 year.
No tumour recurrence was detected during postoperative follow-up examinations. The patients reported neither pain nor presence of paraesthesias. Neurofibromas (17 tumours) predominated in the gathered clinical material, while the second most common group of tumours were schwannomas (12 tumours).
(1) Benign nerve tumours of the hand are rare. Neurofibromas and schwannomas predominate among them. Tumours having other histopathological patterns are extremely uncommon. (2) The prognosis after resection of benign nerve tumours located in the hand is good and the risk of postoperative complications and recurrence is low.
手部神经源性肿瘤在临床实践中较为罕见。本研究旨在介绍我们对手部良性神经肿瘤的手术治疗经验。特别强调确定具有独特组织病理学模式的特定肿瘤类型的发生率,并描述病变的详细位置。评估所获得的治疗结果。
本研究包括26例患者,其中女性19例,男性7例。女性和男性患者的平均年龄及年龄范围分别为44.8岁(范围21 - 73岁)和39.6岁(范围21 - 74岁)。1990年至2013年间,这些患者对手部神经源性肿瘤接受了手术治疗。26例患者共切除31个肿瘤。肿瘤最常见的起源部位是小皮支,仅2例肿瘤起源于指总神经。术后随访无患者失访。术后最短随访期为1年。
术后随访检查未发现肿瘤复发。患者既无疼痛也无感觉异常。在收集的临床资料中,神经纤维瘤(17个肿瘤)占主导,其次是神经鞘瘤(12个肿瘤)。
(1)手部良性神经肿瘤罕见。其中神经纤维瘤和神经鞘瘤占主导。具有其他组织病理学模式的肿瘤极为罕见。(2)手部良性神经肿瘤切除后的预后良好,术后并发症和复发风险低。