Prevalence Study of Patients with Upper Extremity Masses

Yıl 2013, Cilt: 20 Sayı: 1, 40 - 44, 01.02.2013

M. Efe Mirel Kadir Ertem Nurzat Elmalı Mustafa Karakaplan N. Engin Aydın Nurhan Şahin Cihat Dağgez Saim Yoloğlu

Öz

Aim: The soft tissue and bone tumors which are located in the upper extremity usually have a benign character. These lesions which require careful diagnosis and treatment are mostly studied retrospectively and in small series. In this study, we aimed to evaluate the relations of the tumors located in the upper extremity by age, gender, mass location, clinical and pathological diagnosis and their compliance with these diagnoses. Material and Methods: We analyzed the data of 125 patients who were operated between 2000-2011 at Inonu University School of Medicine Department of Orthopedics and Traumatology. 125 patients; 52 male (41.6%), 73 female (58.4%) were enrolled in this retrospective study. The mean age was 36,8 (7-85) years 96.8% of lesions were classified as benign and 3.2% as malign. Results: Histopathological diagnoses were ganglion cysts (28%), enchondromas (11.2%), tendon sheat giant cell tumors (5.6%) and lipomas (5.6%). We noticed that our clinical provisional diagnoses were compatible with pathological diagnoses in 60.8% of frequently seen tumors. Conclusion: The diagnosis is determined in most of upper extremity tumors by simple physical examination, and conventional radiological techniques. We must comply with the rules of tumor treatment and the mainstay of treatment for hand surgery. In benign tumors, the treatment mostly is excisional biopsy but sometimes reconstructive procedures are required. The treatment of malign tumors should be planned in a multidisciplinary management. Key words: Benign; Extremity; Malign; Biopsy; Tumor.

Anahtar Kelimeler

Benign; Extremity; Malign; Biopsy; Tumor.

Üst Ekstremite Kitleleri Olan Hastalarımızın Prevelans Çalışması

Öz

Amaç: Üst ekstremite yerleşimli yumuşak doku ve kemik tümörleri çoğu kez benign karakterdedir. Tanı ve tedavileri büyük özen ve dikkat gerektiren bu lezyonlarla ilgili çalışmaların bir çoğu geriye dönük incelemeler ve küçük olgu serilerinden oluşur. Burada sunulan çalışmada üst ekstremite yerleşimli tümörlerin yaş ve cinsiyet ilişkileri, kitle lokalizasyonu, klinik ön tanı, patolojik tanı ve bu tanıların final tanıyla uyumlarının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu çalışmada İnönü Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı'nda 2000-2011 tarihleri arasında cerrahi olarak tedavi edilen 125 üst eksremite kitlesi olan olgu dosya kayıtlarından retrospektif olarak incelendi. Bu 125 olgunun 52'si erkek (%41,6), 73'ü kadındı (%58,4). Bu olguların yaş ortalaması 36,8 (7-85 yaş) olarak tespit edildi. Bulgular: Üst ekstremite kitle lezyonlarının %96,8'i benign karakterde, %3,2'si ise malign karakterde olarak rapor edilmiştir. . Kitle lokalizasyonu olarak değerlendirildiğinde olguların %28'ini ganglion, %11,2'sini enkondrom, %5,6'sını tendon kılıfının dev hücreli tümörü ve %5,6'sını da lipomun oluşturduğu görüldü. Klinik ön tanılarımızın daha çok sık karşılaşılan tümörlerde, patolojik tanı ile %60,8 oranında uyum sağladığı görülmüştür. Sonuç: Üst ekstremite tümörlerinin çoğunun tanısı, basit bir fizik muayene ve konvansiyonel radyolojik işlemle konulabilir. Üst ekstremite yerleşimli kitlelerin tedavisinde temel tümör ve el cerrahisi kurallarına uymak gerekir. Klinik ve radyolojik bulgular benign tümörü doğrularsa birçoğunda eksizyonel biyopsi yapılabilir. Baz olgularda da rekonstrüktif girişimler gerekebilir. Malign tümörlerde tedavi mutlaka multidisipliner yaklaşımla planlanmalıdır. Anahtar kelimeler: Benign; Ekstremite; Malign; Biyopsi; Tümör.

Anahtar Kelimeler

Benign; Ekstremite; Malign; Biyopsi; Tümör.

Kaynakça

• Herdem M, Bayram H, Sarpel Y, Baytok G. Elin tümör ve tümör benzeri lezyonları. 32. Ulusal Tıp Kongresi. Adana, 1992; 39.
• Athanasian EA. Bone and soft tissue tumors. In: Gren DP, Hotchkiss RN, Pederson W, Wolfe SW, eds. Green’s Operative Hand Surgery. 5th ed. Pennsylvania: Elsevier Churchill Livingstone; 2005: 2211-63.
• Ingari JV, Faillace JJ. Benign tumors of fibrous tissue and adipose tissue in the hand. Hand Clin 2004;20:243-9.
• Posch JL. Tumors of the hand. J Bone Joint Surg 1956;38: 517-40.
• Boyes JH. Bunnel’s Surgery of the Hand. 4th Ed. Philadelphia: J.B. Lippincott Co; 1964.
• Bogumill GP,Sullivan DJ,Baker GI. Tumors of the hand. Clin Orthop 1975;108:214-22.
• Butler ED, Hamil JP, Seipel RS, De Lorimier AA. Tumors of the hand. A ten years survey and report of 437 Cases. Am J Surg 1960;100:293-302.
• Glicenstein J, Ohana J, Leclerc C. Tumors of the Hand. New York: Springer-Verlag; 1988.
• Plate AM, Lee SJ, Steiner G, Posner MA. Tumorlike
• lesions and benign tumors of the hand and the wrist. J Am Acad of Orthop Surg 2003;11:129-41.
• Unni KK, Dahlin DC. Dahlin’s Bone Tumors. 5th Ed, Philadelphia; Lippincott-Raven; 1996.
• Campanacci M. Bone and soft tissue tumors. NewYork; Springer-Verlag: 1990: 677.
• Mankin HJ. Principles of Diagnosis and treatment of tumors of the hand. Hand Clin 1987;3:185–95.
• Fleegler E J. Skin Tumors, Green’s Operative Hand Surgery, Vol-2(68), 1999:2184-205.
• Athanasian E A. Bone and soft tissue tumors. In: Gren DP, Hotchkiss RN, eds. Green’s Operative Hand Surgery. Vol-2(70), 1999:2223-53.
• Angelides AC. Ganglions of the hand and wirst. Green’s Operative Hand Surgery. Vol-2(67), 1999:2171-83.
• Stephan A, Benign and malignant soft tissue tumors of the hand. McCarty Plastic Surgery. Vol-8, part:2-133, W.B. Saunders Company:1990;5483-509.
• Glicenstein J, Ohana J, Leclercq C. Tumors of the hand 1988: 11-13, 3-157.
• Beredjiklian B.,Donthineni-Rao R. Tumors, Review of hand surgery. Part:10, Saunders;2004:189-206.
• Chung KC. Skin tumors. In: Gren DP, Hotchkiss RN, Pederson W, Wolfe SW, eds.Green’s Operative Hand Surgery. Vol2((62), Elsevier; 2005:2191-210.
• Athanasian EA, Bone and soft tissue tumors. Gren DP,
• Hotchkiss RN, Pederson W, Wolfe SW, eds. Green’s Operative Hand Surgery. Vol2(63), Elsevier; 2005:2211-64.
• Koman LA, Ruch DS, Smith BP, Smith TL, Vascular Disorders. In: Gren DP, Hotchkiss RN, Pederson W, Wolfe SW, eds. Green’s Operative Hand Surgery. Vol-2, Chapter-64, Elsevier;2005:2265-313.
• Lucas GL, Benign soft tissue tumors, Plastic Surgery, Vol- 4, Chapter-129, Mosby; 2000:2277-86.
• Hans U.S, Peter M.V, Heinz-Herbert H, Detlev H, Malign soft tissue tumors. Plastic Surgery. Vol-4(130), Mosby; 2000:2287-98.
• Leung P. C. Tumors of hand. The Hand 1981; 13:69-76.
• Chung KC. Skin Tumors. In: Gren DP, Hotchkiss RN, Pederson W, Wolfe SW, eds. Green’s Operative Hand Surgery, 5th ed, Pennsylvania. Elsevier 2005:2191-209.
• Plate AM, Lee SJ, Steiner G, Posner MA. Tumorlike Lesions and Benign Tumors of the hand and the Wrist J Am Acad of Orthop Surg 2003;11:129-41.
• Unni KK, Dahlin DC. Dahlin’s Bone Tumors. 5th Ed, Philadelphia: Lippincott-Raven, 1996.
• Mankin HJ. Principles of diagnosis and treatment of tumors of the hand. Hand Clin 1987;3:185-95.
• McPhee M, McGrath BE, Zhang P, Driscoll D, Gibss J, Peimer C. Soft tissue sarcoma of the hand. The J Hand Surg 1999;24:1001-17.
• Başvuru Tarihi: 15.02.2012, Kabul Tarihi: 07.09.2012
• Mirel ME, Ertem K, Elmalı N, Karakaplan M,
• Aydın NE, Şahin N, Dağgez C, Yoloğlu S.
• Prevalence study of patients with upper extremity
• masses.J Turgut Ozal Med Cent 2013;20(1):40-44 DOI:
• 7247/jtomc.20.1.9