Hand | Neoplasms


Also in the area of the hand it can come to new formations. In principle, these can grow in any anatomical area. These are often benign neoplasms which do not always require surgery. A thorough clarification is important here before the diagnosis can be made.

What are neoplasms?

The generic term new formation of tissue is used in medicine synonymous with tumor. This often leads to anxiety and insecurity in non-medically trained persons, as these are supposedly life-threatening illnesses. However, the term tumour correctly stands for the neutral term that tissue has increased or formed. In the area of the hand, such neoplasms can often be seen early due to the slender anatomy.

In principle, there are benign and malignant neoplasms which have different biological behaviour. To put it simply, benign neoplasms grow locally displacing surrounding tissue and do not make metastasis, while malignant neoplasms tend to destroy locally and can form metastasis. Further biological properties and the initial tissue are very diverse, so that the tumour or the new formation cannot be spoken of. Under the generic term of new formation, many diseases accumulate, ranging from simple soft cysts (ganglion) and benign new formation of fat cells (lipoma) to locally destructively growing soft tissue tumors (sarcoma).

wrist ganglion

When is surgery necessary?

When an operation becomes necessary again depends on the type of new tissue formation. In certain cases, observant behaviour can also be adopted. However, this requires careful clarification. At the beginning there is the diagnosis and based on this the treatment concept is created. Sometimes it is necessary to take samples in order to make the correct diagnosis. Definitive procedures can range from simple incision and suturing to complex reconstruction of bones, tendons and nerves. In addition, collaboration with other disciplines is essential for malignant neoplasms. Combined treatment strategies with chemotherapy or radiation are then necessary. Fortunately, such neoplasms are not frequent in the hand area.

Am I the right candidate?

Whether you are the right candidate again depends on the diagnosis. If you only have a soft tissue cyst (ganglion) and feel little pain, you can take a wait and see approach. In the case of skin neoplasms (e.g. basal cell carcinoma) a surgical procedure is usually necessary. Surgical therapy is more complex for malignant neoplasms. We are happy to explain the diagnosis and the corresponding therapy recommendation in a personal conversation.

What can I expect?

The result again depends on the diagnosis and the therapy. With simple small benign neoplasms, a good to very good result can be achieved with a small scar. For large, complex operations, such final results would be unrealistic. Again, the results to be expected should be discussed in detail during the consultation. In any case, it is often necessary to wait months for the final result.

What happens during consultation hours?

During the initial consultation, we will try to make a diagnosis. In addition to the consultation and the examination, imaging will also be used. Depending on the findings, different imaging techniques such as ultrasound computed tomography or magnetic resonance imaging are used. If the diagnosis is successful, a treatment plan is drawn up. Sometimes the removal of a tissue sample is necessary to make the diagnosis. Then, in a second step, the definitive treatment option is discussed. In each case, a detailed explanation of the planned procedure is given.

What's the surgery like?

Depending on the structures affected by the new formation, the intervention is planned. With simple ganglia a good result can be achieved by a direct excision. If essential structures such as tendons, bones or nerves are affected in malignant neoplasms, complex reconstructions with up to free tissue transfer are necessary. These procedures can range from short outpatient procedures to inpatient procedures lasting several days. In any case, we will discuss the treatment plan with you beforehand.

What about the follow-up treatment?

Since every intervention, no matter how small, involves a certain risk of complications, certain measures should be observed. The first few days you will feel normal, timely pain, which can be relieved with painkillers. For larger operations, in-patient stays are the rule. Regular wound checks are carried out to ensure safe wound healing. Depending on the anatomical region affected, immobilization may also be necessary. A hand-therapeutic accompaniment to mobilisation may also be indicated. All follow-up treatments have in common the goal of early movements with great safety and freedom from pain. The follow-up treatment is already discussed in the initial consultation so that you can plan the postoperative phase already and any help for everyday life and the inability to work can be organized.

What are the risks?

Every intervention, however small, involves a certain risk of complications, since an operation in the broadest sense always leads to tissue injuries. A complication does not necessarily occur due to an error. Rather, the human body reacts individually and has certain tendencies to complications. The initial clarifying discussion serves to address such tendencies and to take appropriate precautions.

General risks of an operation are

  • secondary bleedings
  • wound healing disorders
  • infections
  • Excessive scars
  • thromboses
  • embolisms

Specific risks associated with neoplasms depend on the diagnosis, size and location of the operation. We will be happy to provide you with specific advice as part of the surgical clarification.

Would you like to learn more?

Do you have the impression that you have a new formation or have already been diagnosed?

Often in the area of the hand and forearm the neoplasms can be seen relatively quickly and well due to the anatomical conditions. It is not always accompanied by pain or discomfort, sometimes it is a purely aesthetic problem.

We will be happy to advise you within the framework of an initial consultation on referral by your family doctor or directly with us. Please note whether you are in an HMO or other family doctor model and inform your family doctor. During the initial consultation, we will work out the diagnosis together and, if necessary, take the first therapeutic steps. An operation will always take place later and should be well weighed.

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