82 A Case of Recurrent Calcifying Aponeurotic Fibroma of the Hand: Managing a Rare Hand Tumour in an Evolving Healthcare Landscape

Abstract Introduction Calcifying Aponeurotic Fibroma (CAF) is a rare benign tumour originating from the aponeuroses of tendons and their bony insertions. Our case illustrates technical challenges considerations removing large, recurrent CAF hand. Case Report A 15-year-old student presented to his GP with one-year history progressively enlarging painless swelling on dorsum middle phalanx left finger. Plain radiographs identified calcified soft tissue no involvement. The lesion was excised by local paediatric orthopaedic service recurred rapidly. Histology confirmed diagnosis. He referred our specialist hand surgery overlying skin (which demonstrated histological but not clinical disease). At six months, there evidence recurrence. Conclusions may present atypically, high index suspicion warranted lesions. Excision conservative margins, we newly suggest, skin, recommended preserve function minimise recurrence (very common). Hand provision in UK changing adoption hub spoke model tumours be more appropriately managed at centres.