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Bone metastases of the hand
G Morris1, S Evans1, J Stevenson1
1Royal Orthopaedic Hospital NHS Foundation Trust , UK.
Annals of the Royal College of Surgeons of England
|August 31, 2017
Summary
Malignant hand lesions, often acrometastases, present as non-mechanical hand pain. Early consideration of malignancy is crucial, especially with thumb symptoms or a history of cancer, as prognosis is often poor.
Area of Science:
- Oncology
- Hand Surgery
- Diagnostic Imaging
Background:
- Malignant hand lesions are rare.
- Metastases to the hand (acrometastases) are an uncommon presentation of advanced cancer.
Purpose of the Study:
- To identify patients with malignant hand lesions.
- To determine the proportion of hand metastases.
- To review the clinical course and outcomes of these patients.
Main Methods:
- Retrospective review of a prospective tumor database.
- Inclusion criteria: patients treated for hand metastases.
- Data collected: demographics, primary malignancy site, hand region, management, and outcome.
Main Results:
- 149 malignant hand tumors identified; 10 were metastases.
- Median age 68 years; common symptoms included non-mechanical hand pain.
- Primary sites: skin, lung, kidney, neuroendocrine; thumb most affected.
- Prognosis was poor, with a median survival of 18 months post-diagnosis.
Conclusions:
- Non-mechanical hand pain warrants consideration of malignancy, especially with thumb involvement or prior cancer history.
- Acrometastases indicate advanced disease with a poor prognosis.
- Diagnostic vigilance is key for timely management.
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