Saturday, June 20, 2015

Finger Masses

I see a number of kids with growths on the fingers.  These growth vary tremendously in size and expectations but these are technically tumors. The good news is that almost all of these finger masses are benign- meaning that they don't spread to other parts of the body.  They are still concerning to the family.  It is, therefore, key to have a good sense of what each mass might be so that can better understand the best treatment.

One such growth is infantile digital fibromatosis.  This is a benign growth- typically a bump on the finger or fingers.  It does not hurt.  Often, infantile digital fibromas are small as depicted in this picture from Medscape:

However, these growths can also be much bigger and concerning.  Here is one dramatic example of an infantile digital fibroma.


Infantile Digital Fibroma

Infantile Digital Fibroma

Here are a couple of links with more pictures of infantile digital fibroma:

The key step in evaluation of these bumps is be evaluated by a physician or surgeon with experience.  If the correct diagnosis of infantile digital fibroma is made, observation is recommended because surgery can lead to the bumps coming back bigger (recurrence).  In the case above, there was a biopsy done to make a diagnosis and the bumps did come back even bigger.  Surgery for infantile digital fibromatosis is not curative and is, therefore, typically avoided.  I must admit, however, that this is difficult to accept for the family AND for the surgeon.  Everyone wants this to be cured but unfortunately, there is no easy answer.  The good news is that over time with observation alone, many of patients with infantile digital fibromatosis will find that the lesions spontaneously get smaller or disappear.

Failla, et al nicely summarized the condition at this LINK.

Charles A. Goldfarb, MD
My Bio at Washington University
congenitalhand@wudosis.wustl.edu




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