[Does the metastatic behavior of sarcomas of the hand justify function-maintaining intervention?]

The dangers are emphasised of conservative surgery for soft-tissue malignancy of the hand, based on three cases. In the first, a fibrosarcoma which had developed in a longstanding fistula was treated by partial amputation, lymph node dissection and radiotherapy. Two recurrences arose locally at a later juncture. In the second case, a bone cyst diagnosed a "proliferative synovioma" was resected locally, only to recur on two further occasions being finally characterised as a spindle-cell sarcoma. In the third case, autopsy revealed metastatic Ewing's sarcoma in a patient initially treated by local resection of a "mesenchymal blastoma".