Primary malignant bone tumors of the hand.

Malignant bone tumors of the hand are rare and few centers have extensive experience in the care of patients with these lesions. Eighteen patients with 22 lesions were evaluated at our institution. There were nine chondrosarcomas, four hemangioendothelial sarcomas, two cases each of osteosarcoma and fibrosarcoma, and a single case of Ewing's tumor. The average age of the patients was 39 years. Ten lesions each were located in the metacarpals and phalanges, with two lesions in the carpus. There were nine local recurrences, which appeared at an average of 24.5 months (range, 3 to 74 months). Curettage procedures resulted in the highest rate of local recurrence (85%). Three patients died of metastatic disease. Surgical control of these lesions requires careful preoperative planning and wide surgical margins. Regular oncologic follow-up is necessary.