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| Introduction |
- A benign nodular tumor that is found on the tendon sheath of the hands and feet
- it is most common on palmar surface of radial three digits near DIPJ
- Second most common soft-tissue tumor seen in the hand, following ganglion cyst
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| Presentation |
- Symptoms
- enlarging mass
- pain, worse with activity (or wearing shoes, for foot lesions)
- Physical exam
- firm, nodular mass that does not transilluminate
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| Imaging |
- Radiographs
- pressure-type bone erosion can be seen in up to 5% of patients on radiographs
- MRI
- MRI may be helpful diagnostically
- appearance of the focal form is generally decreased signal intensity on both T1-and T2-weighted MR imaging
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| Histology |
- Characterized by
- proliferating histiocytes, moderately cellular (sheets of rounded or polygonal cells)
- hemosiderin (brown color) may be present, but typically less than seen with PVNS
- multinucleated giant cells are common
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| Treatment |
- Operative
- marginal excision
- 5-50% recurrence rate
- more common if tumor extends into joints and deep to the volar plate
- local recurrence is usually treated with repeat excision
- operative approach is dependant on location and extent of the tumor
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