Plate Ann-Marie, Steiner German, Posner Martin A
New York University School of Medicine, New York, NY, USA.
J Am Acad Orthop Surg. 2006 Nov;14(12):680-92. doi: 10.5435/00124635-200611000-00013.
Malignant tumors in the hand and wrist compose a wide variety of lesions involving skin, soft tissues, and bone. Although these lesions are found elsewhere in the body, many have unique characteristics at this anatomic location. Skin tumors predominate; the most common are squamous cell carcinomas, followed in frequency by basal cell carcinomas and malignant melanomas. Other soft-tissue malignancies are less common but may present more difficult diagnostic problems. They often appear as painless masses that sometimes have been present for months or even years and deceptively appear to be benign. A missed or delayed diagnosis of these tumors can have devastating consequences. Bone malignancies involve both primary lesions, of which chondrosarcomas are the most common, and metastatic lesions. Regardless of cell type, treatment of malignant tumors in the hand and wrist requires special considerations because of the important function of these structures. Orthopaedic surgeons should be familiar with the spectrum of these tumors, the work-up necessary to arrive at a precise diagnosis, and the treatment that will achieve the most favorable outcome.
手部和腕部的恶性肿瘤包括多种累及皮肤、软组织和骨骼的病变。尽管这些病变也见于身体其他部位，但其中许多在这个解剖部位具有独特特征。皮肤肿瘤占主导；最常见的是鳞状细胞癌，其次是基底细胞癌和恶性黑色素瘤。其他软组织恶性肿瘤较少见，但可能带来更棘手的诊断问题。它们常表现为无痛性肿块，有时已存在数月甚至数年，看似良性，实则具有欺骗性。这些肿瘤的漏诊或延误诊断可能产生毁灭性后果。骨恶性肿瘤包括原发性病变（其中软骨肉瘤最常见）和转移性病变。无论细胞类型如何，由于这些结构的重要功能，手部和腕部恶性肿瘤的治疗都需要特殊考虑。骨科医生应熟悉这些肿瘤的范围、做出准确诊断所需的检查以及能取得最理想疗效的治疗方法。
