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Soft Tissue Masses and Cancers of the Hand

What are soft tissue masses and how do they affect the hand?

Soft tissue masses are abnormal lumps or growths that can develop in the muscles, tendons, nerves, fat, or connective tissues of the hand. These may be benign (non-cancerous) or malignant (cancerous), and their presence can affect the function, appearance, and comfort of the hand and wrist.


The hand is a compact structure with many vital components tightly packed together, so even a small mass can interfere with movement or cause discomfort. Many soft tissue masses are painless and grow slowly, but others may cause pain, tingling, weakness, or restriction of motion depending on their size and location.

Early evaluation is crucial. In some cases, a mass may be the first indication of a serious condition like a soft tissue sarcoma or skin cancer, and timely intervention can dramatically affect the outcome.

What types of masses and cancers occur in the hand?

A wide variety of soft tissue masses and tumours can develop in the hand, including:

  • Ganglion cysts: The most common hand mass. These fluid-filled sacs usually develop near joints or tendons and can fluctuate in size. While benign, they may become painful or limit motion.
  • Lipomas: Soft, fatty lumps that are generally painless and slow-growing. Surgical removal is often done for cosmetic reasons or discomfort.
  • Giant cell tumours of the tendon sheath: Benign but locally aggressive, these can press on surrounding structures and may recur after removal.
  • Nerve sheath tumours: Such as schwannomas or neurofibromas, which can cause nerve-related symptoms like numbness or tingling.
  • Skin cancers: Including squamous cell carcinoma, basal cell carcinoma, and melanoma, especially in areas exposed to sunlight.
  • Soft tissue sarcomas: Rare malignant tumours that require urgent surgical management, often followed by oncology support.

Diagnosis and treatment

Diagnosis often begins with a thorough clinical exam, followed by imaging such as ultrasound, X-rays, or MRI to determine the nature and location of the mass. A biopsy may be needed to confirm whether the growth is benign or malignant.

Treatment usually involves surgical excision. For benign masses, the goal is to remove the mass with minimal disruption to surrounding tissues. In the case of malignancies, surgery is more extensive and may include removal of surrounding tissue margins and reconstruction. Some patients may require chemotherapy or radiation depending on the type of cancer.


FAQ

1Do all hand masses need to be removed?
Not always. If a mass is small, painless, and not affecting function, it may simply be monitored. However, suspicious, growing, or symptomatic masses should be removed or biopsied.
2What is recovery like after removal?
Most patients recover quickly from minor mass excisions with minimal downtime. More complex tumour surgeries may require rehabilitation or follow-up treatment.
3Are these conditions life-threatening?
Most soft tissue masses in the hand are benign and not life-threatening. However, early identification and treatment of cancerous lesions are critical to achieving the best outcomes.
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Dr Phalafala's success lies in her collaborative, detail-oriented approach to complex surgery. She develops personalised treatment plans focused on each patient’s unique needs, supported by a foundation of empathy, communication, and clinical excellence. Her goal is to provide transformative outcomes through reconstructive and cosmetic surgery that not only enhance form and function but also restore confidence and quality of life.

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