Demographics and Prediction Accuracy of Upper Extremity Tumors

Abstract

Background: Upper extremity tumors (UETs) and their treatment may impair hand functions. Successful prediction of the histopathological examination before surgery will speed up the treatment process. The aim of this study is to determine the frequency and prediction accuracy of tumors encountered in the upper extremity. Patients and Methods: Records of patients operated for UETs between January 2010 and December 2019 were reviewed. Patient gender, initial complaint, the anatomic region of the tumor, comorbidities predisposing to malignancy, method of biopsy, preliminary diagnosis and predicted malignancy status after initial examination, definitive histopathological diagnosis, and malignancy status were extracted retrospectively. Prediction accuracy rates were calculated for each tumor group. Chi-square analysis was used for comparative analysis of prediction accuracy rates between cutaneous pigmented versus soft-tissue lesions and patients with/without a predisposition to malignancy. Results: The study included 416 pathological specimens from 290 patients. The most common tumors of the upper extremity were lipoma (20%), ganglion cyst (10.1%), and epidermoid cyst (5.8%). After pathological evaluation, 23 specimens were diagnosed as malignant (5.5%) and 32 specimens as premalignant (7.7%). The prediction of malignancy status was accurate in 390 specimens (93.7%). Soft-tissue sarcomas (67.7%) and vascular lesions (58.1%) have the lowest accuracy rates among all tumors. Conclusion: Definitive diagnosis and malignity status can be predicted after the initial examination in the majority of the cases. However, imaging studies or incisional biopsies are needed for soft-tissue sarcomas, vascular tumors, or tumors of patients with a predisposing condition to malignancy.