PMC9091399_01
Swelling on palmar aspect of hand.
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F1
In January 2021, a 20-year-old male presented with swelling over the right hand for 5 years, insidious in onset, progressive in nature, located over the medial border on the palmar side (Fig.1 and 2). On clinical examination, the swelling was of size 4 cm x 3 cm x 2 cm (Fig.1 and 2), bony hard, irregular surface, adherent to the underlying bone with no coronal or sagittal plane movement possible.
Swelling on medial border of hand.
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F2
In January 2021, a 20-year-old male presented with swelling over the right hand for 5 years, insidious in onset, progressive in nature, located over the medial border on the palmar side (Fig.1 and 2). On clinical examination, the swelling was of size 4 cm x 3 cm x 2 cm (Fig.1 and 2), bony hard, irregular surface, adherent to the underlying bone with no coronal or sagittal plane movement possible.
Plain radiograph showing lesion on the 5th metacarpal from different angles.
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F3
Magnetic resonance imaging showing lesion from different views.
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F4
TR x SI) sized bony overgrowth seen arising from distal metaphyseal region of 5th metacarpal bone showing continuity with a medullary cavity in growing away from epiphysis (Fig. 4). This lesion is seen displacing the 5th flexor digitorum profundus tendon laterally and causing compression over flexor digiti minimi and abductor digiti minimi muscles.
Intraoperative image shoeing bony tumor.
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F5
Osteochondroma excised under general anesthesia and tourniquet control, the bony swelling was approached through the posteromedial incision (Fig. 5).
Excised tumor.
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F6
Tumor of size approximately 3 x 2 cm was excised from the root of the pedicle (Fig. 6).
(1) Homogeneous cartilaginous tissue; (2) interosseous connective tissue; (3) bony trabeculae; (4) endochondral ossification.
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F7
HPR did not show any mitotic activity or necrosis in the sections studied (Fig. 7).
Post-operative check radiograph taken 1 day after excision of tumor.
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F8
Post-operative period was uneventful, check x-ray of the hand was taken on day 1 with satisfactory findings (Fig. 8), regular dressing was done and sutures were removed on post-operative day 12.
Post-operative check radiograph taken 1 year after excision of tumor.
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F9
At 1 year of follow up patient was evaluated radiologically (Fig. 9) and clinically (Fig. 10) with satisfactory outcome.