Frassica F J, Amadio P C, Wold L E, Dobyns J H, Linscheid R L
Department of Orthopedics, Mayo Clinic, Rochester, Minn 55905.
J Hand Surg Am. 1989 Nov;14(6):1022-8. doi: 10.1016/s0363-5023(89)80054-1.
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.
手部恶性骨肿瘤较为罕见，很少有中心在治疗这些病变患者方面拥有丰富经验。我们机构对18例患者的22处病变进行了评估。其中有9例软骨肉瘤、4例血管内皮肉瘤、骨肉瘤和纤维肉瘤各2例，以及1例尤因肉瘤。患者的平均年龄为39岁。掌骨和指骨各有10处病变，腕骨有2处病变。出现了9次局部复发，平均发生时间为24.5个月（范围为3至74个月）。刮除术导致的局部复发率最高（85%）。3例患者死于转移性疾病。对这些病变进行手术控制需要仔细的术前规划和广泛的手术切缘。定期的肿瘤学随访是必要的。
