Palmar Fibromatosis: an Analysis of 25 Cases

Abstract

Objective: Dupuytren’s contracture (DC) is a benign tumor that results in nodular or fibrous band-like thickening of the palmar fascia and leadsto palmar and digital contractures. Although they are benign lesions, post-operative recurrence is frequent. In the present study, we retrospectivelyanalyzed clinicopathological findings of 25 cases that underwent surgery for DC. We also aimed to determine the relationship between relapse andKi-67 proliferation index and smooth muscle actin (SMA) staining intensity in excision materials by immunohistochemical method.Methods: The demographic characteristics, severity of contracture, treatment type, Ki-67 proliferation index, SMA staining intensity and recurrencewere evaluated retrospectively in 25 patients who were operated with the diagnosis of DC at the Department of Orthopedics and Traumatology inRecep Tayyip Erdogan University between 2009 and 2015.Results: The age range of the patients was 42-75 years (mean age: 55 years), and 6 were female and 19 were male. Fifteen of the lesions were in theright hand, and 10 were in the left hand. All patients underwent extensive palmar fascia excision with regional intravenous anesthesia. Only onepatient had recurrence. Ki-67 proliferation index was 1-2% in patients without recurrence, however, >5% nuclear positivity was detected in a patientwith recurrence. In addition, strong positive staining for SMA was observed in this patient.Conclusion: The use of Ki-67 proliferation index and SMA staining intensity to evaluate fibroblastic proliferation in the pathological examination ofsurgical DC specimens may be valuable in clinical follow-up in terms of recurrence.