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Malignant Tumors of the Hand and Wrist

Dr. Plate is Assistant Professor, New York University School of Medicine, and Assistant Attending Physician, Hand Service, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases, New York, NY. Dr. Steiner is Professor of Surgical Pathology, New York University School of Medicine, and Chairman, Department of Pathology, NYU–Hospital for Joint Diseases. Dr. Posner is Clinical Professor of Orthopaedics, New York University School of Medicine, and Chief of Hand Service, Department of Orthopaedic Surgery, NYU–Hospital for Joint Diseases.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Plate, Dr. Steiner, and Dr. Posner.

Reprint requests: Dr. Posner, 2 East 88th Street, New York, NY 10128.

Malignant tumors in the hand and wrist compose a wide variety of lesions involving skin, soft tissues, and bone. Although these lesions are found elsewhere in the body, many have unique characteristics at this anatomic location. Skin tumors predominate; the most common are squamous cell carcinomas, followed in frequency by basal cell carcinomas and malignant melanomas. Other soft-tissue malignancies are less common but may present more difficult diagnostic problems. They often appear as painless masses that sometimes have been present for months or even years and deceptively appear to be benign. A missed or delayed diagnosis of these tumors can have devastating consequences. Bone malignancies involve both primary lesions, of which chondrosarcomas are the most common, and metastatic lesions. Regardless of cell type, treatment of malignant tumors in the hand and wrist requires special considerations because of the important function of these structures. Orthopaedic surgeons should be familiar with the spectrum of these tumors, the work-up necessary to arrive at a precise diagnosis, and the treatment that will achieve the most favorable outcome.