Angioleiomyoma of the pulp

Angioleiomyoma of the hand with nerve compression

Objective

This study was performed to analyze the clinical, radiographic, and pathological features of hand angioleiomyoma causing nerve compression and assess the outcomes of surgical excision.

Methods

This case series included three men and one woman (mean age, 53.3 years; range, 49–56 years). The patients’ chief complaint was numbness of the fingers. The patients’ medical histories were reviewed, and the diagnosis of angioleiomyoma with nerve compression was confirmed by means of imaging examination and pathological analysis.

Results

Three tumors occurred in the palm and one in the finger, and the average maximum tumor diameter was 1.8 cm (range, 0.8–2.6 cm). Preoperative magnetic resonance imaging demonstrated well-defined masses with isointense signals on T1 sequences, hyperintense signals on T2 sequences, and strong heterogeneous enhancement after injection of contrast material. All tumors were located near nerves, leading to nerve compression. The diagnosis of angioleiomyoma was confirmed by postoperative pathology. Finger sensation recovered and no recurrence was found during an average follow-up of 37 months (range, 25–59 months).

Conclusions

Angioleiomyoma should be considered among the differential diagnoses of hand tumors and timely resection should be performed, particularly if the mass is causing numbness and/or pain with positive Tinel’s sign and/or tenderness.

Primary Hand Leiomyoma: A Systematic Review

BACKGROUND

Primary leiomyoma is a rare cause of a mass in the hand, with few reported cases to date. To our knowledge, this constitutes the most comprehensive and up-to-date systematic review of the literature of all cases of primary hand leiomyoma. We also provide an additional case recently managed in our practice of confirmed primary vascular leiomyoma of the hand in a 44-year-old woman to add to the current body of literature.

METHODS

We performed a comprehensive literature review of all articles published on primary leiomyoma of the hand. The PubMed database was used, with search terms leiomyoma hand, angioleiomyoma hand, and angiomyoma hand. Articles were selected for their accuracy in anatomic localization in the hand and confirmed pathology of leiomyoma.

RESULTS

Our initial search query resulted in 216 articles. After applying the inclusion criteria, we identified 50 individual articles with 108 cases of confirmed primary leiomyoma in the hand from January 1, 1954, to July 1, 2018. Common initial clinical impressions recorded for primary hand leiomyoma included ganglion cyst, giant-cell tumor, hemangioma, and glomus tumor. Patients presenting with leiomyoma of the hand frequently describe a painful lesion, which differs from most other benign tumors of the hand at presentation.

CONCLUSIONS

Leiomyoma is an important consideration when developing a differential diagnosis for primary benign masses in the hand. We hope that this comprehensive review can provide increased awareness of this tumor type.

Meta-ranking de universidades. Posicionamiento de las universidades españolas

Este estudio propone la elaboración de un meta-ranking con las 14 universidades españolas que aparecen en al menos cuatro de los cinco rankings globales considerados, que son de reconocida notoriedad internacional. Se puede diferenciar entre rankings de investigación con datos bibliométricos y rankings que tienen en cuenta otros aspectos y otras formas de recabar datos basadas en encuestas. Las universidades españolas alcanzan mejores posiciones en los primeros que en los segundos. Se pone de relieve una debilidad mayor en la internacionalización, la reputación o el ratio estudiante-profesor que en los indicadores de investigación. Son excepción las universidades que destacan en las dos dimensiones. A la vista de estas conclusiones resulta evidente la necesidad de profundizar en una mayor internacionalización, en mejorar la reputación y mejorar la visibilidad internacional de la universidad española.