Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a progressively enlarging, firm, non-tender mass in the [location: e.g., dorsal aspect of the hand/proximal phalanx]. Duration of symptoms is [number] months. Patient denies history of trauma, constitutional symptoms, or prior surgical intervention. No associated paresthesia or motor deficit noted.
Clinical Examination Findings
Physical examination reveals a [size: e.g., 3cm] firm, fixed, deep-seated mass. Overlying skin is intact without ulceration or erythema. Neurovascular status is intact with capillary refill <2 seconds and preserved sensation in the median, ulnar, and radial nerve distributions. Range of motion of the involved digit/hand is [limited/full]. No palpable axillary or epitrochlear lymphadenopathy.
Treatment Protocol
Recommended management includes urgent MRI of the hand/wrist with and without contrast for staging. Core needle biopsy or incisional biopsy is indicated for histopathological confirmation. Surgical planning involves wide local excision with negative margins, potentially requiring reconstructive techniques (flaps/grafts) or ray amputation depending on neurovascular involvement and tumor grade. Multidisciplinary tumor board review is mandatory.