1. Foreign Body Granuloma
Management
Curettage and bone graft (if bony)
Excision of lump
- recurrence very unusual
2. Osteochondroma
Xray
Cortical flow evident
3. Brown's tumour
Causes
Primary hyperparathyroidism
Secondary hyperparathyroidism
- CRF
X-ray
Lytic lesion
- often seen in distal phalanx
4. Nora's lesion
Bizarre parosteal osteochondroma
5. Neurofibroma
Not possible to dissect free
- need to excise
- end to end anastomoses
6. Synovial Chondromatosis
Diffuse swelling
May have calcification
7. Juvenile Aponeurotic Fibroma
Benign fibrous tumour
- occurs in the hands of children and young adults
- no gender predeliction
- no tendency to involve ulnar digits as with Dupuytren's disease
Calcification is distinguishing feature
- locally infiltrative
Management
Requires wide local excision without sacrifice of function
- local recurrence common
Metastatic fibrosarcoma after local recurrence of JAF reported
- careful follow up required
8. Recurring Digital Fibrous Tumor of Childhood
Benign fibrous tumour that develops in fingers and toes in infants and children
- distinguished histologically by intracytoplasmic inclusion bodies within proliferating fibroblasts
Probable viral aetiology
- usually on several digits and intradermal
- recurrence rate up to 60%
Marginal excision if function compromised
No malignant potential
- spontaneous regression described
9. Malignant Tumours
Metastasis
- very rare
- 50% lung cancer
Chondrosarcoma
- most common
- chemo and radio insensitive
- only treatment is surgery
Osteosarcoma and Ewings
- quite rare
Dermatofibrosarcoma / Epitheloid Sarcoma / Synovial Sarcoma