Pseudomalignant, nonneoplastic osseous soft-tissue tumors of the hand and foot

Seventeen patients with nonneoplastic osseous tumors in the soft tissues of the hands and feet were retrospectively studied. Three of the patients had a reliable history of trauma. Ten patients showed periosteal reaction associated with gradual formation of an osseous soft-tissue tumor, sometimes with a peripheral zone of bone density. Histologically (also radiographically), the lesions may be mistaken for malignant neoplasms such as osteosarcoma or parosteal osteosarcoma, especially when the pathologist does not receive representative material. In this series, malignancy was suspected in eight patients. Radiologic and pathologic criteria that may be helpful in the differential diagnosis of this lesion are presented. It is important that this nonneoplastic, benign, and self-limiting process in the hands and feet be recognized and treated accordingly. Local excision is adequate therapy in most cases, with little risk of local recurrence.