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Epidemiological, clinical and histological features of adipose tumors in the hand and wrist: Findings from a continuous series of 37 cases - 10/04/20

Doi : 10.1016/j.otsr.2019.12.011 
Émilie Marteau a, Louis-Romée Le Nail b, Philippe Rosset b, Gonzague de Pinieux c, Jacky Laulan a, Steven Roulet a, Guillaume Bacle a, d,
a Unité de chirurgie de la main, Hôpital Trousseau, CHRU de Tours, Tours, France 
b Service de Chirurgie Orthopédique et Traumatologique, Réunion de Concertation Pluridisciplinaire d’Oncologie de l’Appareil Locomoteur, Hôpital Trousseau, CHRU de Tours, Tours, France 
c Service d’Anatomie et de Cytologie Pathologiques, Réunion de Concertation Pluridisciplinaire d’Oncologie de l’Appareil Locomoteur, Hôpital Trousseau, CHRU de Tours, Tours, France 
d UMR 1253 Imagerie et Cerveau (iBrain), Faculté de Médecine, Université de Tours, Tours, France 

Corresponding author at: Unité de chirurgie de la main, Hôpital Trousseau, CHRU de Tours, UMR 1253 Imagerie et Cerveau (iBrain), Faculté de Médecine, Université de Tours, avenue de la République, 37170 Chambray-Lès-Tours, France.Unité de chirurgie de la main, Hôpital Trousseau, CHRU de Tours, UMR 1253 Imagerie et Cerveau (iBrain), Faculté de Médecine, Université de Toursavenue de la RépubliqueChambray-Lès-Tours37170France

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Abstract

Introduction

Adipose tumors are the most common soft tissue tumor in adults; however, their epidemiology and histology in the hand and wrist are not well-defined. The aim of this study was to describe the histology and treatment strategy for this type of tumor at a specialized cancer center.

Hypothesis

The frequency of these tumors is underestimated, and their histology signature varies.

Materials and methods

The clinical and paraclinical data of adults treated for an adipose tumor lesion in the hand or wrist were analyzed retrospectively: age, clinical history, time elapsed between discovery and treatment, type of treatment. The dimensions, location and histology of the tumor were collected. The patients were contacted to inquire about persistent symptoms and sequelae.

Results

Thirty-seven tumors (37 patients) were included between January 2003 and December 2018, thus making up 7.5% of all the soft tissue tumors in the hand or wrist. The mean patient age was 59years (28–84years). Except for one fortuitous discovery, the tumors were discovered because the patient had an unusual lump. The lump was associated with distal paresthesia in six cases. The mean time to treatment was 47.5months (1–240months). The lesion was a conventional lipoma (31 cases) or one of its benign variants (6 cases). The mean size was 3.76cm in the long axis (1–11.5cm) and the mean weight was 9.8g (3–60g). The mean follow-up was 73.5months (2–177months). Tumors in the fingers were smaller and lighter than those in the wrist (p=0.004 and p=0.034).

Discussion

The prevalence of adipose tumors is underestimated within hand and wrist tumors. The most common way these tumors are discovered is due to compressive neuropathy with paresthesia and/or dysesthesia. While these tumors are nearly always benign, this does not justify ignoring the opinion of the multidisciplinary tumor board or underestimating the small possibility of the lesion being a liposarcoma.

Level of evidence

IV, retrospective, single-center study.

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Keywords : Adipose tumor, Lipoma, Hand, Wrist, Histology


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Vol 106 - N° 2

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