[Sarcomas of the hand]

The hand is a very rare localization for sarcomas. We evaluated patients who underwent surgical treatment for sarcoma of the hand.

Between 1990 and 2006, eight patients (5 males, 3 females; mean age 39.6 years; range 26 to 67 years) with hand sarcoma received treatment at two centers. The lesions arose from soft tissue in five cases, and from bone in three cases. Localizations were fingers (n=3), carpal region (n=2), and the wrist (n=3). Radiologic assessments included plain radiographs, magnetic resonance imaging, and scintigraphy in all the patients, with addition of computed tomography for bone tumors. All the patients underwent biopsies for precise diagnosis. Staging was made according to the Enneking classification. Tumors involving the fingers were treated with digital amputation, while the rest were treated with wide resection. The mean follow-up was 48 months (range 6 to 123 months).

Mortality occurred in two patients due to multiple metastases, who had synovial sarcoma in the carpal region and clear cell sarcoma in the wrist, respectively. Both patients had stage III disease on presentation. Of three patients with tumors localized in the fingers, two had stage IA, and one had stage IB disease. Apart from clear cell sarcoma, diagnoses of other wrist tumors were stage IIB epithelioid sarcoma and malignant fibrous histiocytoma. Of six patients who were alive, hand functions were sufficient in four, fair in one, and poor in one. None of the patients developed local recurrences.

Due to rarity of malignant hand tumors, diagnosis and treatment require considerable attention. It was observed that patients maintained a good psychological status by avoiding complete amputation of the hand and performing an appropriate wide resection with reconstruction.