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Published on: April 18, 2015
Inflammatory myofibroblastic tumor of the hand: A case report
Hui Lu1, Hui Shen1, Xiang-Qian Shen1
1Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China.
Insights
A rare inflammatory myofibroblastic tumor (IMT) in the hand was misdiagnosed as cellulitis. Prompt biopsy and conservative surgery led to successful treatment with no recurrence and good hand function.
Area of Science:
- Oncology
- Hand Surgery
- Pathology
Background:
- Inflammatory myofibroblastic tumors (IMTs) are rare neoplasms.
- IMTs of the hand are uncommon and frequently misdiagnosed as infections like cellulitis.
- Accurate diagnosis and timely intervention are crucial for optimal outcomes.
Purpose of the Study:
- To report a case of inflammatory myofibroblastic tumor (IMT) of the hand.
- To highlight the diagnostic challenges and emphasize the importance of early and correct diagnosis.
- To discuss the management and surgical approach for hand IMTs.
Main Methods:
- Histological examination of hand ulcers initially diagnosed as cellulitis.
- Surgical resection of the involved tissue, preserving tendons and nerves.
- 2-year follow-up to assess tumor recurrence and hand function.
Main Results:
- Histological analysis confirmed an inflammatory myofibroblastic tumor (IMT).
- The patient underwent conservative surgical resection.
- No signs of tumor recurrence were observed after 2 years, with good hand function.
Conclusions:
- Inflammatory myofibroblastic tumors (IMTs) in the hand are rare and can be mistaken for infections.
- Biopsy is essential for recurrent or persistent lesions after debridement.
- A conservative surgical approach is recommended to preserve hand function.
Abstract:
The present study reports the case of a 58-year-old male patient who repeatedly presented with hand ulcers that were diagnosed as cellulitis. Upon histological analysis, however, an inflammatory myofibroblastic tumor (IMT) was diagnosed. IMTs rarely occur in the hands. The involved tissue was removed with the tumor, with the exception of the tendons and cutaneous nerve. The involved tendon sheath and epineurium were carefully resected. After 2 years of follow-up, the patient showed no signs of tumor recurrence and the hand function was good. IMTs in the hands are relatively rare, and are often easily misdiagnosed as infection. An early and correct diagnosis is the key to successful treatment. A biopsy is necessary following debridement of the infected lesion, particularly for recurrent infected lesions. The surgical approach should be conservative, in order to maintain maximum hand function.