Subscribe to RSS
DOI: 10.1055/s-0041-1724017
Hand Masses
Abstract
Hand and wrist soft tissue masses may be classified as pseudotumors, benign neoplasms, or malignant neoplasms. The vast majority of hand lesions are benign. Consideration of the location of the lesion and its imaging characteristics often leads to a specific diagnosis. Pseudotumors discussed in this article are ganglion cysts, accessory muscles, and inflammatory lesions. True tumors are described according to their tissue type: nerve sheath tumors, adipocytic tumors, so-called fibrohistiocytic tumors, pericytic tumors, and vascular lesions. We also outline the imaging features of masses encountered in the hand and wrist.
Publication History
Article published online:
03 June 2021
© 2021. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
-
References
- 1 Capelastegui A, Astigarraga E, Fernandez-Canton G, Saralegui I, Larena JA, Merino A. Masses and pseudomasses of the hand and wrist: MR findings in 134 cases. Skeletal Radiol 1999; 28 (09) 498-507
- 2 Stack HG. Tumors of the hand. BMJ 1960; 1 (5177): 919-922
- 3 Teh J, Whiteley G. MRI of soft tissue masses of the hand and wrist. Br J Radiol 2007; 80 (949) 47-63
- 4 Sookur PA, Saifuddin A. Indeterminate soft-tissue tumors of the hand and wrist: a review based on a clinical series of 39 cases. Skeletal Radiol 2011; 40 (08) 977-989
- 5 Teh J. Ultrasound of soft tissue masses of the hand. J Ultrason 2012; 12 (51) 381-401
- 6 Bianchi S, Della Santa D, Glauser T, Beaulieu J-Y, van Aaken J. Sonography of masses of the wrist and hand. AJR Am J Roentgenol 2008; 191 (06) 1767-1775
- 7 Khaled W, Drapé JL. MRI of wrist and hand masses. Diagn Interv Imaging 2015; 96 (12) 1238-1246
- 8 Vanhoenacker FM, Eyselbergs M, Van Hul E, Van Dyck P, De Schepper AM. Pseudotumoural soft tissue lesions of the hand and wrist: a pictorial review. Insights Imaging 2011; 2 (03) 319-333
- 9 Calleja M, Dimigen M, Saifuddin A. MRI of superficial soft tissue masses: analysis of features useful in distinguishing between benign and malignant lesions. Skeletal Radiol 2012; 41 (12) 1517-1524
- 10 Kuhn KJ, Cloutier JM, Boutin RD, Steffner R, Riley G. Soft tissue pathology for the radiologist: a tumor board primer with 2020 WHO classification update. Skeletal Radiol 2020; (August): 1-14
- 11 Gude W, Morelli V. Ganglion cysts of the wrist: pathophysiology, clinical picture, and management. Curr Rev Musculoskelet Med 2008; 1 (3-4): 205-211
- 12 Teefey SA, Dahiya N, Middleton WD, Gelberman RH, Boyer MI. Ganglia of the hand and wrist: a sonographic analysis. AJR Am J Roentgenol 2008; 191 (03) 716-720
- 13 Balazs GC, Dworak TC, Tropf J, Nanos III GP, Tintle SM. Incidence and Risk Factors for Volar Wrist Ganglia in the U.S. Military and Civilian Populations. J Hand Surg Am 2016; 41 (11) 1064-1070
- 14 Andrén L, Eiken O. Arthrographic studies of wrist ganglions. J Bone Joint Surg Am 1971; 53 (02) 299-302
- 15 Wang G, Jacobson JA, Feng FY, Girish G, Caoili EM, Brandon C. Sonography of wrist ganglion cysts: variable and noncystic appearances. J Ultrasound Med 2007; 26 (10) 1323-1328 ; quiz 1330–1331
- 16 Anderson SE, Steinbach LS, Stauffer E, Voegelin E. MRI for differentiating ganglion and synovitis in the chronic painful wrist. AJR Am J Roentgenol 2006; 186 (03) 812-818
- 17 Vanhoenacker FM, Desimpel J, Mespreuve M, Tagliafico A. Accessory muscles of the extremities. Semin Musculoskelet Radiol 2018; 22 (03) 275-285
- 18 Sookur PA, Naraghi AM, Bleakney RR, Jalan R, Chan O, White LM. Accessory muscles: anatomy, symptoms, and radiologic evaluation. Radiographics 2008; 28 (02) 481-499
- 19 Stevens KJ, Theologis T, McNally EG, Stevens K. Imaging of plant-thorn synovitis. Skeletal Radiol 2000; 29 (10) 605-608
- 20 Horton LK, Jacobson JA, Powell A, Fessell DP, Hayes CW. Sonography and radiography of soft-tissue foreign bodies. AJR Am J Roentgenol 2001; 176 (05) 1155-1159
- 21 Jacobson JA, Powell A, Craig JG, Bouffard JA, van Holsbeeck MT. Wooden foreign bodies in soft tissue: detection at US. Radiology 1998; 206 (01) 45-48
- 22 Monu JUV, McManus CM, Ward WG, Haygood TM, Pope Jr TL, Bohrer SP. Soft-tissue masses caused by long-standing foreign bodies in the extremities: MR imaging findings. AJR Am J Roentgenol 1995; 165 (02) 395-397
- 23 Jin W, Ryu KN, Kim GY, Kim HC, Lee JH, Park JS. Sonographic findings of ruptured epidermal inclusion cysts in superficial soft tissue: emphasis on shapes, pericystic changes, and pericystic vascularity. J Ultrasound Med 2008; 27 (02) 171-176 ; quiz 177–178
- 24 Hoang VT, Trinh CT, Nguyen CH, Chansomphou V, Chansomphou V, Tran TTT. Overview of epidermoid cyst. Eur J Radiol Open 2019; 6: 291-301
- 25 Teh J, McQueen F, Eshed I, Plagou A, Klauser A. Advanced imaging in the diagnosis of gout and other crystal arthropathies. Semin Musculoskelet Radiol 2018; 22 (02) 225-236
- 26 Ogdie A, Taylor WJ, Neogi T. et al. Performance of ultrasound in the diagnosis of gout in a multicenter study: comparison with monosodium urate monohydrate crystal analysis as the gold standard. Arthritis Rheumatol 2017; 69 (02) 429-438
- 27 Yu Z, Mao T, Xu Y. et al. Diagnostic accuracy of dual-energy CT in gout: a systematic review and meta-analysis. Skeletal Radiol 2018; 47 (12) 1587-1593
- 28 Starok M, Eilenberg SS, Resnick D. Rheumatoid nodules: MRI characteristics. Clin Imaging 1998; 22 (03) 216-219
- 29 Takashima S, Ota M. Methotrexate-induced nodulosis. CMAJ 2015; 187 (10) E327
- 30 Sudoł-Szopińska I, Jans L, Teh J. Rheumatoid arthritis: what do MRI and ultrasound show. J Ultrason 2017; 17 (68) 5-16
- 31 WHO Classification of Tumours Editorial Board. WHO Classification of Tumours of Soft Tissue and Bone. 5th ed.. Lyon, France: IARC Press; 2020
- 32 Murphey MD, Rhee JH, Lewis RB, Fanburg-Smith JC, Flemming DJ, Walker EA. Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 2008; 28 (05) 1493-1518
- 33 Middleton WD, Patel V, Teefey SA, Boyer MI. Giant cell tumors of the tendon sheath: analysis of sonographic findings. AJR Am J Roentgenol 2004; 183 (02) 337-339
- 34 Ferrando PM, Garagnani L, Eckersley R, Weir J, Katsarma E. Lipomatous tumours of the hand and wrist. A series of 25 cases and review of the literature. Ann Ital Chir 2014; 85 (06) 587-592
- 35 Rahmani G, McCarthy P, Bergin D. The diagnostic accuracy of ultrasonography for soft tissue lipomas: a systematic review. Acta Radiol Open 2017; 6 (06) 2058460117716704
- 36 Bancroft LW, Kransdorf MJ, Peterson JJ, O'Connor MI. Benign fatty tumors: classification, clinical course, imaging appearance, and treatment. Skeletal Radiol 2006; 35 (10) 719-733
- 37 Silverman TA, Enzinger FM. Fibrolipomatous hamartoma of nerve. A clinicopathologic analysis of 26 cases. Am J Surg Pathol 1985; 9 (01) 7-14
- 38 Brodwater BK, Major NM, Goldner RD, Layfield LJ. Macrodystrophia lipomatosa with associated fibrolipomatous hamartoma of the median nerve. Pediatr Surg Int 2000; 16 (03) 216-218
- 39 Whittle C, Schonstedt V, Schiappacasse G. Fibrolipomatous hamartoma and its ultrasound diagnosis: case series and review of the literature. Ultrasound Q 2014; 30 (04) 282-286
- 40 Marom EM, Helms CA. Fibrolipomatous hamartoma: pathognomonic on MR imaging. Skeletal Radiol 1999; 28 (05) 260-264
- 41 Suzuki K, Yasuda T, Suzawa S, Watanabe K, Kanamori M, Kimura T. Fibroma of tendon sheath around large joints: clinical characteristics and literature review. BMC Musculoskelet Disord 2017; 18 (01) 376
- 42 Carter JM, Wang X, Dong J, Westendorf J, Chou MM, Oliveira AM. USP6 genetic rearrangements in cellular fibroma of tendon sheath. Mod Pathol 2016; 29 (08) 865-869
- 43 Ogata D, Takeji M, Murakami T, Yanagisawa H, Kuramochi A, Tsuchida T. Comparison of ultrasonographic findings of schwannomas and angioleiomyomas. J Dermatol 2018; 45 (07) 837-843
- 44 Ge Y, Guo G, You Y. et al. Magnetic resonance imaging features of fibromas and giant cell tumors of the tendon sheath: differential diagnosis. Eur Radiol 2019; 29 (07) 3441-3449
- 45 Molenkamp S, van Straalen RJM, Werker PMN, Broekstra DC. Imaging for Dupuytren disease: a systematic review of the literature. BMC Musculoskelet Disord 2019; 20 (01) 224
- 46 Morris G, Jacobson JA, Kalume Brigido M, Gaetke-Udager K, Yablon CM, Dong Q. Ultrasound features of palmar fibromatosis or Dupuytren contracture. J Ultrasound Med 2019; 38 (02) 387-392
- 47 Yacoe ME, Bergman AG, Ladd AL, Hellman BH. Dupuytren's contracture: MR imaging findings and correlation between MR signal intensity and cellularity of lesions. AJR Am J Roentgenol 1993; 160 (04) 813-817
- 48 Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 1999; 19 (05) 1253-1280
- 49 Ryu JA, Lee SH, Cha E-Y, Kim TY, Kim S-M, Shin MJ. Sonographic differentiation between schwannomas and neurofibromas in the musculoskeletal system. J Ultrasound Med 2015; 34 (12) 2253-2260
- 50 Beggs I. Sonographic appearances of nerve tumors. J Clin Ultrasound 1999; 27 (07) 363-368
- 51 Beggs I. The ring sign: a new ultrasound sign of peripheral nerve tumours. Clin Radiol 1998; 53 (11) 849-850
- 52 Suh JS, Abenoza P, Galloway HR, Everson LI, Griffiths HJ. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology 1992; 183 (02) 341-346
- 53 Lee SK, Kim JY, Lee YS, Jeong HS. Intramuscular peripheral nerve sheath tumors: schwannoma, ancient schwannoma, and neurofibroma. Skeletal Radiol 2020; 49 (06) 967-975
- 54 Mautner VF, Friedrich RE, von Deimling A. et al. Malignant peripheral nerve sheath tumours in neurofibromatosis type 1: MRI supports the diagnosis of malignant plexiform neurofibroma. Neuroradiology 2003; 45 (09) 618-625
- 55 Ferner RE, Golding JF, Smith M. et al. [18F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) as a diagnostic tool for neurofibromatosis 1 (NF1) associated malignant peripheral nerve sheath tumours (MPNSTs): a long-term clinical study. Ann Oncol 2008; 19 (02) 390-394
- 56 Society for the Study of Vascular Anomalies. ISSVA Classification of Vascular Anomalies. 2018 Accessed December 15, 2020 at: ssva.org/classification
- 57 Ernemann U, Kramer U, Miller S. et al. Current concepts in the classification, diagnosis and treatment of vascular anomalies. Eur J Radiol 2010; 75 (01) 2-11
- 58 Merrow AC, Gupta A, Patel MN, Adams DM. 2014 Revised Classification of Vascular Lesions from the International Society for the Study of Vascular Anomalies: Radiologic-Pathologic Update. Radiographics 2016; 36 (05) 1494-1516
- 59 Drapé JL, Feydy A, Guerini H. et al. Vascular lesions of the hand. Eur J Radiol 2005; 56 (03) 331-343
- 60 Moukaddam H, Pollak J, Haims AH. MRI characteristics and classification of peripheral vascular malformations and tumors. Skeletal Radiol 2009; 38 (06) 535-547
- 61 Fayad LM, Hazirolan T, Bluemke D, Mitchell S. Vascular malformations in the extremities: emphasis on MR imaging features that guide treatment options. Skeletal Radiol 2006; 35 (03) 127-137
- 62 Morey VM, Garg B, Kotwal PP. Glomus tumours of the hand: review of literature. J Clin Orthop Trauma 2016; 7 (04) 286-291
- 63 Fan Z, Wu G, Ji B. et al. Color Doppler ultrasound morphology of glomus tumors of the extremities. Springerplus 2016; 5 (01) 1319
- 64 Fornage BD. Glomus tumors in the fingers: diagnosis with US. Radiology 1988; 167 (01) 183-185
- 65 Al-Qattan MM, Al-Namla A, Al-Thunayan A, Al-Subhi F, El-Shayeb AF. Magnetic resonance imaging in the diagnosis of glomus tumours of the hand. J Hand Surg [Br] 2005; 30 (05) 535-540
- 66 Hwang JW, Ahn JM, Kang HS, Suh JS, Kim SM, Seo JW. Vascular leiomyoma of an extremity: MR imaging-pathology correlation. AJR Am J Roentgenol 1998; 171 (04) 981-985
- 67 McPhee M, McGrath BE, Zhang P, Driscoll D, Gibbs J, Peimer C. Soft tissue sarcoma of the hand. J Hand Surg Am 1999; 24 (05) 1001-1007
- 68 Murphey MD, Gibson MS, Jennings BT, Crespo-Rodríguez AM, Fanburg-Smith J, Gajewski DA. From the archives of the AFIP: imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 2006; 26 (05) 1543-1565
- 69 Morton MJ, Berquist TH, McLeod RA, Unni KK, Sim FH. MR imaging of synovial sarcoma. AJR Am J Roentgenol 1991; 156 (02) 337-340
- 70 Jones BC, Sundaram M, Kransdorf MJ. Synovial sarcoma: MR imaging findings in 34 patients. AJR Am J Roentgenol 1993; 161 (04) 827-830
- 71 Romero JA, Kim EE, Moral IS. MR characteristics of epithelioid sarcoma. J Comput Assist Tomogr 1994; 18 (06) 929-931
- 72 Casanova M, Meazza C, Favini F, Fiore M, Morosi C, Ferrari A. Rhabdomyosarcoma of the extremities: a focus on tumors arising in the hand and foot. Pediatr Hematol Oncol 2009; 26 (05) 321-331
- 73 De Beuckeleer LH, De Schepper AM, Vandevenne JE. et al. MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review. Skeletal Radiol 2000; 29 (04) 187-195
- 74 Noebauer-Huhmann IM, Weber MA, Lalam RK. et al. Soft tissue tumors in adults: ESSR-approved guidelines for diagnostic imaging. Semin Musculoskelet Radiol 2015; 19 (05) 475-482
- 75 Dangoor A, Seddon B, Gerrand C, Grimer R, Whelan J, Judson I. UK guidelines for the management of soft tissue sarcomas. Clin Sarcoma Res 2016; 6 (01) 20
- 76 Macpherson RE, Pratap S, Tyrrell H. et al. Retrospective audit of 957 consecutive 18F-FDG PET-CT scans compared to CT and MRI in 493 patients with different histological subtypes of bone and soft tissue sarcoma. Clin Sarcoma Res 2018; 8 (01) 9