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Selected Publication:
Maier, N.
Tumors and tumor-like lesions on the hand and wrist in children and adolescents
Humanmedizin; [ Diplomarbeit ] Medizinische Universität Graz; 2023. pp. 92
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- Authors Med Uni Graz:
- Advisor:
- Singer Georg
- Weitzer Claus-Uwe
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- Abstract:
- Tumors of the hand or wrist are commonly seen in children and adolescents. In most cases these are ganglion cysts. Differential diagnosis include giant cell tu-mors, vascular malformations and numerous other tumor related conditions. The aim of this study was to describe tumors and tumor-like lesions of the hand and the wrist and to examine their differences. The retrospective study examined data from all patients with swellings on the hand or wrist who were treated surgically between 2005 and 2022 at the Depart-ment of Pediatric and Adolescent Surgery at the Medical University of Graz. In addition to the sex and age of the patients, parameters of clinical presentation and characteristics of the entities like size, location, site, hand dominance, pain, change of size, as well as other parameters for surgery, inpatient stays, recur-rences and complications were collected. The patients were divided into cohorts based on age, time to presentation, location and size of pathology. A total of 229 patients were included. Of these, 64% were female (n=147) and 36% (n=82) male, with a female-to-male ratio of 1.8:1. The average age of the pa-tients was 11.4 years. Most common pathologies were ganglion cysts (n=164, 72%) followed by vascular malformations (n=24, 11%) and giant cell tumors (n=11, 5%). Out of the 164 patients with ganglion cysts, 116 were female (71%) and 48 male (29%). Symptoms of ganglion cysts were change of size (n=63, 38%) and/or pain (n=108, 66%). Moreover, pain occurred more often in females (n=82, 71%) than in males (n=26, 54%). The most common location was the wrist (n=129, 79%) followed by the metacarpals (n=18, 11%). The back of the hand was more often affected (n=114, 70%) than the palm (n=49, 30%) equally for both genders. The left side (n=85, 52%) was more often affected than the right side (n=74, 45%), both sides were affected in 5 patients (3%). The patients´ average age at operation was 12,53 years. The mean time between diagnosis and opera-tion was 157 days. In 13% of all cases (n=22) the ganglion cyst recurred after sur-gical excision. In 91% the cysts recurred once. Six patients (3.7%) had postopera-tive complications. In many aspects the data in this study confirms the already existing literature. Ganglion cysts most commonly affect the dorsal hand and wrist and there is a female predominance. It was confirmed that in younger children cysts are smaller in size and are more common on the palm of the hand. Older children and ado-lescents suffered from pain more often than younger ones if ganglia were pre-sent. Regarding the size of the lesion there was a difference depending on gen-der. There were also results in giant cell tumors and vascular malformations that are important for the differential diagnosis of swellings.