Hand Tumors - Photos & Info
Below you will be provided with photographs and information from the surgeries of patients with HAND TUMORS

SURGERY OF PATIENT I:

This shows a yellowish mass arising from the palm side of the left middle finger. The patient had slight pain and restriction of motion as her symptoms that caused her to present to my office. Once in the operating room we identified this mass and it was a very clear example of what is known as a giant cell tumor of the tendon sheath.

 

The following image demonstrates the superficial flexor tendon to the left side of the area of the mass and the mass can be seen between the two metal forceps.  It is a multilobular mass arising from the palm side of the proximal interphalangeal joint, which is one of the knuckles of the hand. 

 

The next image demonstrates that complete removal of this mass, which is now sitting on the skin of the palm. One can see the intact flexor tendons and digital nerves in the field.

 

Postoperatively, she has gone on to do very well and has no evidence of recurrence at three years.

SURGERY OF PATIENT II:

This patient presented to my office with a palmar mass on the little finger side of the wrist. He was taken to the operating room and this area was explored. The results of our exploration are shown in the frame. The dotted purple lines indicate the ulnar nerve on the right side of the screen demonstrated by the right foam pointer, and also on the left side of the skin as demonstrated by the pointer. The mass in the middle of the frame indicates a nerve sheath tumor which is also called a Schwannoma.

We went on to resect this mass and one can see between the pointers intact nerve fibers that remained after its removal. We then went on to close and postoperatively the patient has done well, has excellent sensation in the ulnar nerve distribution and is free of any recurrence at six years.



SURGERY OF PATIENT III:

This is a gentleman who presented with a relatively large mass on the palm side of his left middle finger. One can see it outlined in a circular
manner with dots of ink. The continuous zig-zag line represents the proposed incision.



The following image demonstrates this patient’s mass from a lateral view, demonstrating to the observer the substantial size and nature of the mass.

 

The next frame demonstrates the large nature of the cystic mass that has arisen and is a result of a skin injury. The nerves have been protected  throughout the course of the procedure to provide for good sensation in the fingertip postoperatively.

 

In the next frame, one can see the palmar mass sitting in the mid-palm and the defect in the finger is shown before closure.


SURGERY OF PATIENT IV:

This patient was a female who presented to the office with a rather large palmar mass. Because of its distinct abnormality, we took her to the operating room to remove this. Interoperatively, one can see the mass indicated by the white triangular foam pointer. The lower white foam pointer on the image demonstrates the unusual mass pushing up on the digital nerve indicated by the purple line that is now curved. The other foam pointer demonstrates the digital nerve on the thumb side of the index finger. These nerves supply sensation to the palm side of the tip of the finger.


One can see the removed abnormal fatty tumor which was present in between the index and middle fingers. The nerves were preserved intact throughout the procedure.


One can see the size of the mass which is really quite large for something occurring on the palm or a finger.


The patient has gone on to heal very nicely and has full range of motion and good sensation.


SURGERY OF PATIENT V:

This indicates a subtle but real cystic mass on the thumb side of the palm of the hand near the wrist.

 

That light shiny spot represents a cystic mass called a ganglion cyst.

 

In the next image, one can see the ganglion cyst after careful dissection.

 

After the cyst was removed, the patient went on to heal uneventfully and has done well.


SURGERY OF PATIENT VI:

This is a gentleman in his 50’s who presented with a recurrent mass on the palm side of his right index finger.

 

The mass is indicated by the dotted circular area and the proposed incision is indicated by the solid line. The next image indicates the flaps on the palm side of the finger have been raised and the structures with the dotted purple lines are the digital nerves providing sensation to the tip of the finger. The reader is to understand that when we operated on the finger, one of the first priorities is to identify and preserve the nerves so that good sensation can be maintained after the procedure. In the midst of the exposed operative field, one can see the cystic mass which has arisen.

 

In the following image, one can see from a side view, the variant large nature of the mass.


 The image below indicates the size of the tumor.





SURGERY OF PATIENT VII:

This is a case of a man who developed an abnormality for an overgrowth of the veins of his right forearm. An incision has been made and we have dissected out what is called a venous lake.

 

Indicates our complete dissection of the venous lake. The feeding vessel is indicated on the left side of the screen going into the convoluted mass and the drainage vessels are indicated on the right side of the image that allows blood to exit from this mass.

 

 

Again, we see the feeding and draining vessels pointed out.


This mass was excised.  The feeding and draining vessels were secured and the patient has done very well.



 

 

 

 



 









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