Amadio P C, Lombardi R M
J Hand Surg Am. 1987 Mar;12(2):311-6. doi: 10.1016/s0363-5023(87)80299-x.
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.
在43年期间，我院共治疗了18例手部有22处转移病灶的患者。12处病灶位于远端指骨，其余病灶见于腕骨、掌骨、近端指骨和手部软组织。原发肿瘤5例位于肺部，5例位于肾脏。治疗方法包括近端病灶行局部切除或放疗，远端病灶行截肢术。尽管中位生存期仅5个月，但5例患者存活超过2年；其中2例无恶性疾病的进一步证据。2例患者中，手部转移是恶性疾病的首发症状。手部炎性病变的鉴别诊断应考虑转移性恶性肿瘤。虽然一般来说，治疗目标应为姑息治疗，但在一些患者中，广泛切除转移灶可实现较长的无病间期。
