Carrillo-Córdova JR, Victor-Baldín A, Jiménez-Murat Y, Apellaniz CAG, Bracho-Olvera H, Carrillo-Córdova CA

Language: Spanish
References: 8
Page: 22-25
PDF size: 165.02 Kb.

ABSTRACT

Introduction: Vascular anomalies in the hand represent a rare disease that needs an accurate diagnosis and a prompt surgical treatment. One of these uncommon anomalies is the mixed vascular malformation. The diagnosis of these malformations is clinical, but radiological studies such as magnetic resonances and Doppler ultrasounds are mandatory. Once the diagnosis is made, surgery is the next and final step. Recurrence is rare when the entire tumor is resected.
Clinical Case Study: A 35-year-old male presented with an increase in volume and pain of three months of evolution in the right hand. On physical examination, a mass in the righthand thenar region was observed, with well-defined edges of approximately 3 x 3 cm, not mobile, adhered to deep planes, painful to palpation, with hyperesthesias in the median nerve pathway. A magnetic resonance and a Doppler ultrasound were applied showing a well-circumscribed tumor. The patient underwent surgery and the whole vascular malformation was removed with no damage of neighbor structures. Pathology reported a venous and capillary hemangioma.
Conclusions: Mixed vascular malformations in the hand are uncommon pathologies that require a correct diagnosis and a prompt surgical resolution. The most frequent symptoms associated with these tumors are: pain and limitation in the movement of the hand. Surgical treatment is always recommended.

REFERENCES

1. Tang P, Hornicek FJ, Gebhardt MC, Cates J, Mankin HJ. Surgical treatment of hemangiomas of soft tissue. Clin Orthop Relat Res. 2002;399:205-10.

2. Dayicioglu D, Martell EG, Ogilvie M, Gozu A, Panthaki ZJ, Armstrong MB. Vascular anomalies of the upper extremity in children. J Craniofac Surg. 2009;20:1025-9.

3. Wassef M, Blei F, Adams D, et al. Vascular anomalies classification: Recommendations from the international society for the study of vascular anomalies. Pediatrics. 2015;136:1-12.

4. Palmieri TJ. Subcutaneous hemangiomas of the hand. J Hand Surg Am. 1983;8:201-4.

5. Al-Qattan MM. Adquired localized subcutaneous cavernous vascular malformations of the hand. J Hand Surg Br. 2004;29;139-43.

6. Webster G, Geschickter G. Bening capillary hemangioma of digital flexor tendón sheath. Ann Surg. 1945;122:444-8.

7. Lee DY, Hwang SC, Jeong ST, et al. The value of diagnostic ultrasonography in the assessment of a glomus tumor of the subcutaneous layer of the forearm mimicking a hemangioma: a case report. J Med Case Rep. 2015;9:191.

8. Agarwal A, Prakash M, Gupta P, et al. Soft tissue masses of hand: a radio pathological correlation. Radiol Res Pract. 2015;75:2054-9.