Abstract:

Introduction : Tumors of the hand are very common, they are divided into: pseudotumors (non-neoplastic enlargements) and begnin/malignant neoplasms. Soft tissue tumors of the hand arise from skin (fibrokeratoma), subcutaneous tissue (lipoma), tendons, nerve (neurofibroma), and blood vessels (glomus tumor). Case report: A 48-year-old right-handed patient, presented 2 years ago a painless flesh-colored swelling pulp of the right thumb, there was no functional impairment or history of trauma, but the patient complained of discomfort during thumb movements due to the increase size of the nodule. There was no exostosis at the x-ray, the soft tissue ultrasound revealed an isoechogenic tissue mass with peripheral vascularization. An excisional biopsy was carried out showing a yellow encapsulated and multi-lobed mass. At the histological examination variable proportions of mononuclear cells, osteoclast-like giant cells, foamy histiocytes and hemosiderin laden histiocytes were seen. Discussion: GCCTS of the hands are tumors that affect adults (30 -50 years-old). Clinically, it presents as a firm subcutaneous digital swelling developing next to the proximal or distal metacarpophalangeal or interphalangeal joints, the localization at the wrist is rare, it has never been described in the pulp. MRI highlight the tumor, its size and its exact location. The diagnosis is confirmed by the histology which shows the presence of polynuclear histiocytes dispersed between collagen fibers. Surgery is the main treatment, recurrences occur in 45% of cases due to incomplete excision.The peculiarity of our observation is the localization of the tumor (pulp far from the joints), that misleads the clinical diagnosis which was corrected by the histological study. GCCTS tumors are well known to rheumatologists and traumatologists. It must therefore be evoked by a dermatologist in front of any painless chronic swollen finger.

Financial Disclosure:
No current or relevant financial relationships exist.

Menu

Farah El Hadadi, MD