McEvenue Giancarlo, Kim Ashley, Binhammer Paul
University of Toronto, Ontario, Canada.
University of Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Hand (N Y). 2017 Mar;12(2):NP22-NP26. doi: 10.1177/1558944716669085. Epub 2016 Sep 23.
The differential for soft tissue tumors of the hand and upper limb is broad. Hematologic malignancy remains quite low on the differential for soft tissue tumors involving the hand, and there is little in the literature describing surgical management of such cutaneous manifestations. When the tumor is large or involves the thumb, careful consideration of reconstructive options is required. We present a rare case of an aggressively enlarging mycosis fungoides, a cutaneous T-cell lymphoma tumor, involving the thumb. This tumor had a history of multiple failed treatment attempts, including radiation and chemotherapy. Our surgical plan was a reverse radial forearm osteocutaneous flap. A reverse radial osteocutaneous forearm flap was successfully used to avoid thumb amputation and preserve thumb function.
手部和上肢软组织肿瘤的鉴别诊断范围很广。血液系统恶性肿瘤在手部软组织肿瘤的鉴别诊断中所占比例仍然很低，而且文献中很少描述此类皮肤表现的手术治疗方法。当肿瘤较大或累及拇指时，需要仔细考虑重建方案。我们报告了一例罕见的侵袭性增大的蕈样肉芽肿，这是一种累及拇指的皮肤T细胞淋巴瘤肿瘤。该肿瘤有多次治疗失败的病史，包括放疗和化疗。我们的手术方案是采用桡骨前臂逆行骨皮瓣。桡骨前臂逆行骨皮瓣成功用于避免拇指截肢并保留拇指功能。
