Tırnak Altı Lezyonlarında Cerrahi Yaklaşım

Year 2021, , 421 - 428, 25.12.2021

Ali Gökkaya , Burçin Acuner , Metin Görgü

https://doi.org/10.29058/mjwbs.905342

Abstract

Amaç: Tırnak bölgesinde birçok farklı doku bir arada olduğundan görülen tümöral lezyonlar oldukça
çeşitlidir. Pigmente veya nonpigmente olabilen benign tümörler genellikle daha sıklıkla gözükür ancak
sadece muayene ile benign-malign tümör ayrımının yapılması zordur. Bunun dışında tümöral olmayan
tırnak hastalıklarının da ayırıcı tanıda yer alması gerektiği unutulmamalıdır.
Gereç ve Yöntemler: Bu çalışmada 2009-2020 tarihleri arasında tırnakta kitle şikayetiyle iki farklı
merkezdeki plastik cerrahi kliniklerine başvuran 12 hasta dahil edilmiştir. Hastaların klinik bulguları,
yapılan tedaviler ve sonuçları değerlendirilmiştir.
Bulgular: Her iki plastik cerrahi kliniğine ortalama yaşları 45,9 (34-58) olan 12 hasta başvurmuştur.
Hastalardan 11’i cerrahi tedavi edilmiş, bir hasta tedavi edilmemiştir. Histopatolojik tanı olarak bir hastada
ganglion kisti, beş hastada glomus tümörü ve beş hastada lineer nevüs tanısı konulmuştur. Opere
edilen 11 hastanın 10’unda hastaların tedavi sonucu çok iyi olarak değerlendirilmiştir. Glomus tümörü
olan bir hastada nüks görülmüş ve hasta tekrar opere edilmiştir ve nüks gözlenmemiştir.
Sonuç: Tırnak yatağındaki lezyonlar sıklıkla hastalar tarafından göz ardı edilmektedir. Hem benign,
hem de malign lezyonlar benzer bulgular verebileceğinden tanı için biyopsi alınması şarttır. Uygun
tedavi biyopsi sonucuna göre belirlenmelidir.

Keywords

tırnak hastalıkları, pigmentasyon, melanom, glomus tümörü, ganglion kisti

Surgical Approach in Subungual Lesions

Abstract

Aim: Since there are many different tissues in the nail area, the tumoral lesions seen are quite diverse.
Benign tumors that can be pigmented or nonpigmented are usually seen more often, but it is difficult to
distinguish between benign and malignant tumors by examination alone. Apart from this, it should be
kept in mind that non-tumoral nail diseases should also be included in the differential diagnosis.
Material and Methods: In this study, 12 patients who presented to two different centers with the
complaint of a mass in the nail between 2009-2020 were included. Clinical findings, treatments and
results of the patients were evaluated.
Results: Twelve patients with a mean age of 45.9 (34-58) applied to both clinics. 11 of the patients were
treated surgically, one patient was not treated. Histopathological diagnosis was ganglion cyst in one
patient, glomus tumor in five patients and linear nevus in five patients. In 10 of the 11 operated patients,
the treatment result of the patients was evaluated as very good. Recurrence was observed in one
patient with glomus tumor and the patient was re-operated and no recurrence was observed.
Conclusion: Lesions in the nail bed are often overlooked by patients. Since both benign and malignant
lesions may give similar findings, biopsy is essential for diagnosis. The appropriate treatment should be
determined according to the biopsy result.

Keywords

nail diseases, pigmentation, melanoma, glomus tumor, ganglion cyst

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