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wrist and hand, distal radius/ulna

A 27 year old man with a four month history of a mass in his palm

Submitted by henry on Thu, 11/05/2009 - 18:06
Case Identification
Case ID Number: 
20091105CR
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 27 year old man presented with a four month history of a mass in his palm. He had no history of trauma. Examination showed a firm, fixed, slightly tender mass in the palm of his right dominant hand. The balance of the exam and the laboratory results were unremarkable.

Differential Diagnosis: 
The differential should include surface lesions that form bone, such as osteochondroma, exostosis, heterotopic ossification, bizarre parosteal osteocartilagenous proliferation, periosteal osteosarcoma, parosteal osteosarrcoma, and periosteal chondroma.
Image Reference: 
Bizarre Parosteal Osteochondromatous Proliferation in the hand
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A bone tumor in the finger

Submitted by henryd on Thu, 04/26/2012 - 08:10
Case Identification
Case ID Number: 
20120426TF
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

The 34-year-old man has a 2 year history gradual growth of a slightly tender mass on the index finger. There is no other significant medical history or exam finding.

Radiological findings:: 
There is a mass on the dorso-radial surface of the middle phalanx, with a slight abnormality in the cortex.
Laboratory results:: 
no laboratory analysis was made.
Differential Diagnosis: 
The differential diagnosis will include surface lesions.
Special Features of this Case:: 
Surface lesions are a special group of tumors, and since there are only a few tumors in this group, the list of possibilities is short. A surface lesion on the phalanx of a finger or toe, especially with the xray features this one has, is a "classic" presentation of one tumor in particular. Which one is it? For exam purposes, students should memorize the names of all surface lesions along with their features.
Image Reference: 
A bone tumor in the finger
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A classic bone tumor of the finger

Submitted by henryd on Tue, 12/11/2012 - 16:01
Case Identification
Case ID Number: 
20121210CT
Benign/Malignant: 
unknown
Clinical case information
Case presentation: 

A 20 year old woman has a slowly growing mass adjacent to the ulnar aspect of the middle phalanx of her ring finger. It has been present for 18 months, and is minimally painful. She is otherwise well and there are no other pertinent findings.

Radiological findings:: 
A lucent lesion on the surface of the phalanx with a shallow saucer shaped defect area on the cortex and buttressing of the sides of the lesion at the proximal and distal ends.
Laboratory results:: 
None available
Differential Diagnosis: 
A surface lesion of the bones that can occur in the finger, or a common tumor of the fingers that can affect the bone?
Further Work Up Needed:: 
None
Pathology results:: 
pending
Treatment Options:: 
the right treatment depends on getting the diagnosis right - what is your diagnosis?
Special Features of this Case:: 
The patient was treated at the HEODRA hospital in Leon, Nicaragua
Image Reference: 
A classic bone tumor of the finger
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Aneurysmal Bone Cyst

Aneurysmal bone cyst (ABC) is a solitary, expansile and erosive lesion of bone. The cause of this non-neoplastic lesion is unknown.
Most patients are under 20, but the tumor can occur at any age.
The tumor presents with pain for several weeks with local swelling. Any bone may be involved, but the most common sites include the long bones and the posterior parts of the spinal vertebra.On xrays, the lesion has a destructive, lytic, and expansile appearance.
Most ABC's are sucessfully treated with curettage and packing with bone chips or bone cement.

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