Soft Tissue Masses of the Hand: A Review of Clinical Presentation and Imaging Features

Abstract

More than 15% of all soft-tissue tumors arise in the hand. Because of the location of these tumors, even small abnormalities may be alarming to patients on presentation. Although the majority of lesions are benign and can be diagnosed solely by history and physical examination, additional imaging workup may be required to confirm a diagnosis or define anatomic extent of involvement. This paper aims to review the basic epidemiology, clinical presentation, imaging findings, and treatment options of the more common soft-tissue tumors of the hand.

Benign Tumors of the Wrist, Hand, and Fingers

“…However, in those cases where soft-tissue tumors affect function and dexterity, cause neuropathy, result in vascular compromise, or lesion malignancy is in doubt, then surgical excision is the treatment of choice. Thomas V. Gocke, DMSc, PA-C, DFAAPA 1 1 Orthopaedic Educational Services, Inc., Morgantown, West Virginia E-mail address for T.V. Gocke: osteojunky@ gmail.com…”

“…Like wrist ganglions, mucous cysts will transilluminate and maybe fluctuate in size, depending on the quantity of viscous fluid filling the cyst 6 . Heberden's nodes are osteoarthritic and marginal osteophytes that can be associated with digital mucous cysts 1,2 . Aspiration can be therapeutic and diagnostic (clear, viscous fluid) but difficult to perform in small cysts.…”

“…Tenosynovial giant cell tumors (TGCTs) are the second most common tumor in the hand [1][2][3][4]6,7 . When TGCT occurs in an intra-articular space, it is called pigmented villonodular synovitis 1 . Giant cell tumors present as a slowgrowing, firm, and painless volar nodule 2 .…”

“…Ganglion cysts, fatty tumors, fibrolipomatous hamartomas, and glomus tumors also contribute to the differential diagnosis of peripheral nerve tumors [1][2][3][4]11 . A schwannoma is the most common benign tumor involving peripheral nerves [1][2][3][4]11 . Schwannomas affect men and women equally and occur at any age but are frequently seen in the 30 to 60-year age group 3,4,11 .…”

Intratendinous ganglion cyst of extensor indicis propius tendon: A case report

“…The incidence of hand tumors is unknown, despite the fact that they are extremely prevalent. However, most of them are soft tissue origin (70–84 % of all hand tumors) and are essentially benign [1] . Of those, ganglion cysts are the most prevalent and account for about 65 % of all masses in the wrist and hand.…”