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 leads to palmar and digital contractures. Although they are benign lesions, post-operative recurrence is frequent. In the present study, we retrospectively analyzed clinicopathological findings of 25 cases that underwent surgery for DC. We also aimed to determine the relationship between relapse and Ki-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 recurrence were evaluated retrospectively in 25 patients who were operated with the diagnosis of DC at the Department of Orthopedics and Traumatology in Recep 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 the right hand, and 10 were in the left hand. All patients underwent extensive palmar fascia excision with regional intravenous anesthesia. Only one patient had recurrence. Ki-67 proliferation index was 1-2% in patients without recurrence, however, >5% nuclear positivity was detected in a patient with 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 of surgical DC specimens may be valuable in clinical follow-up in terms of recurrence.