Metastatic tumors of the hand

During a 43-year period, 18 patients with 22 lesions metastatic to the hand were treated at our institution. Twelve lesions were located in the distal phalanges, and the remainder were found in the carpus, metacarpals, proximal phalanges, and soft tissues of the hand. The primary tumor was in the lung in five cases and in the kidney in five cases. Treatment consisted of local excision or radiation for proximal lesions and amputation for distal lesions. Although the median survival was only 5 months, five patients lived longer than 2 years; including two who had no further evidence of malignant disease. In two patients, hand metastasis was the first sign of malignant disease. Metastatic malignancy should be considered in the differential diagnosis of inflammatory lesions of the hand. Although in general, the goal of treatment should be palliation, in some patients long disease-free intervals can be provided by wide excision of the metastatic focus.