DOI: 10.33631/sabd.1976077 ISSN: 2792-0542

Pathological Spectrum, MRI–Pathology Agreement, and Recurrence Rates in 246 Surgically Excised Finger Masses

Enver İpek, Yusuf Altuntaş, Bahadır Balkanlı, Mehmet Ali Bozca, Mehmet Akif Köse, Muhammed Mansuroğlu, Osman Tuğrul Eren
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Aim: To describe the pathological distribution of surgically excised finger masses, evaluate the agreement between preoperative magnetic resonance imaging and histopathology, and identify factors associated with local recurrence.Material and Methods: This retrospective single-centre cohort included 246 patients who underwent excision of a histopathologically confirmed finger mass between 2014 and 2025. Imaging–pathology agreement was assessed using Cohen's kappa, and factors associated with recurrence were evaluated using binary logistic regression.Results: Thirty-two distinct diagnoses were identified. Giant cell tumour of the tendon sheath was the most common (96 cases, 39.02%), and three lesions were malignant (1.22%); in two the finger lesion was the presenting site of a sarcoma later found to have metastasised to the lung, and one patient died during follow-up. Imaging–pathology agreement was 56.10% for the individual diagnosis and 72.36% across the six pathological groups (kappa 0.565, moderate), and was highest in synovial and tendon sheath lesions. Recurrence occurred in 20 patients (8.13%). On multivariable analysis, dorsal localisation (odds ratio 3.92, 95% CI 1.46–10.53, p = 0.007) and younger age (odds ratio OR 0.969, 95% CI 0.941–0.997, p = 0.033) remained associated with recurrence in the multivariable model.Conclusion: Finger masses are pathologically diverse and histopathological confirmation is essential in all excised lesions. Magnetic resonance imaging shows moderate agreement that varies markedly across tumour groups. Dorsal localisation may serve as a preoperative risk marker, but because surgical margin status was unavailable, its prognostic value independent of resection adequacy requires prospective confirmation.

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