Suspected adipose tumours of the hand and the potential risk for malignant transformation to sarcoma: a series of 14 patients.
BACKGROUND
Lipomas are associated with a variety of symptoms including neuropathies, local compression of the surrounding tissues, aesthetic complaints and may be graded as liposarcomas histologically. This study was performed to review our surgical management at the level of the hand.


METHODS
Between 2008 and 2013, 14 patients were referred to our department for suspected adipose tumour of the hand. Preoperative MRI was used to assess tumour and surrounding tissue to plan the surgical therapy. We reviewed the clinical history, MRI findings, surgical approach, and outcomes.


RESULTS
Complaints leading to consultation were pain in 11 cases, compression neuropathy in 7 cases, aesthetic concern in 8 cases, and limited wrist range of motion in 2 cases. Magnetic resonance imaging was performed in 13 cases, confirming the diagnosis of adipose tumour in all but two cases. These two cases were diagnosed in one case as a ganglion and the other as an epithelioid sarcoma. An amputation of the fifth digit was performed regarding the latter case and the patient received additional radiotherapy. The mean follow-up period was 32 ± 20 months. There was no recurrence of lipoma or sarcoma.


CONCLUSIONS
MRI is useful for diagnosing and planning of the surgical intervention performed in the latter case adipose tumours. Rapidly evolving tumours with subfascial localization are absolute surgical indications. Incision biopsy is mandatory for entities of unknown dignity and for malignant tumours. Interdisciplinary tumour board meetings should discuss each patient before surgery is performed.


METHODS
IV.
Department of Plastic-, Transsexual-, Burn- and Hand Surgery, University Hospital of Bordeaux, CHU Bordeaux, Centre François-Xavier-Michelet, Groupe Hospitalier Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux, France, franckleclere@yahoo.fr.
Franck Marie
FM
Leclère
Vincent
V
Casoli
Philippe
P
Pelissier
Peter M
PM
Vogt
Emilie
E
Desnouveaux
Christian
C
Spies
Romain
R
Weigert
Hussein
H
Choughri
D000328:Adult; D000368:Aged; D002471:Cell Transformation, Neoplastic; D005260:Female; D045888:Ganglion Cysts / Q000473:pathology / Q000601:surgery; D006225:Hand / Q000601:surgery; D006801:Humans; D008067:Lipoma / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000473:pathology* / Q000601:surgery