Purpose
Upper limb masses are one of the most common presentations in the outpatient setting.
However, there is a paucity of information in the literature regarding the epidemiology
of upper-extremity masses in the pediatric population. The aim of this study was to
determine the differential diagnoses and clinical characteristics in children aged
≤18 years presenting with upper limb masses.
Methods
A retrospective review of patients aged ≤18 years managed at our institution over
a 5-year period was performed. We obtained information on patient demographics, clinical
features, radiological investigations, intraoperative features, and histology. We
also evaluated the correlation between the clinical and histopathological diagnoses
in patients who underwent surgery.
Results
There were 141 upper limb masses in our series. The mean age at presentation was 12
years (SD, 5 years). The most common presenting complaints were asymptomatic swelling,
pain, and paresthesia. The majority (128; 91%) of tumors were benign; there were 5
locally aggressive tumors and 6 malignant tumors. The dominant hand was involved in
60 patients. Of 140 patients, 43 (31%) patients had surgery. The procedures included
incisional biopsy, excisional biopsy, wide resection, and reconstruction. One patient
required a below elbow amputation for an osteosarcoma.
Conclusions
Ten percent of cases represented malignant or locally aggressive disease. We have
used our observations to develop a clinical algorithm that can assist clinicians in
evaluating and managing children and adolescents presenting with upper-extremity masses.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: July 30, 2021
Accepted:
June 16,
2021
Received:
May 21,
2020
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
