MacGillis Kyle J, Heaberlin James, Mejia Alfonso
Department of Orthopaedic Surgery, Stony Brook University, Stony Brook, NY.
Department of Orthopaedic Surgery, University of Illinois at Chicago, Chicago, IL.
J Hand Surg Am. 2018 Dec;43(12):1123-1129. doi: 10.1016/j.jhsa.2018.03.032. Epub 2018 Jun 19.
Evaluation of a hand mass and subsequent surgical treatment is a frequent clinical encounter for the practicing hand surgeon. The clinical evaluation of benign and malignant hand tumors has traditionally focused on diagnosis, surgical excision, and reconstruction. There is a paucity of literature discussing the determining factors for a hand mass biopsy, its appropriate technique, and postbiopsy preparation and handling. This review discusses the approaches of the hand surgeon and orthopedic oncologist to a soft tissue mass in the hand and clarifies the term biopsy. Special attention is focused on preoperative decisions and indications for core needle, incisional, and excisional biopsies of hand masses. In addition, we include a discussion of surgical technique for obtaining a specimen, processing a specimen, and sending a specimen for pathological evaluation. This highlights specimen labeling and type of fixative utilized for pathological evaluation. This review features a section detailing clinical strategies to reduce morbidity associated with evaluation and treatment of benign and malignant hand masses and is based on recommendations from a synopsis of expert opinion and literature review.
对于执业手外科医生而言，手部肿块的评估及后续手术治疗是常见的临床情况。传统上，手部良恶性肿瘤的临床评估主要集中在诊断、手术切除和重建方面。关于手部肿块活检的决定因素、合适技术以及活检后处理的文献较少。本综述讨论了手外科医生和骨肿瘤学家对手部软组织肿块的处理方法，并阐明了活检这一术语。特别关注手部肿块的粗针活检、切开活检和切除活检的术前决策及适应证。此外，我们还讨论了获取标本、处理标本以及送检标本进行病理评估的手术技术。这突出了标本标记和用于病理评估的固定剂类型。本综述设有一个章节，详细阐述了降低手部良恶性肿块评估和治疗相关发病率的临床策略，该章节基于专家意见综述和文献回顾的建议撰写。
