Distribution and Characteristics of Carpal Bone Tumors: A Systematic Review.

Carpal bone tumors are rare in the literature, making it difficult to identify their clinical presentation.  This systematic review analyzes the characteristics of published carpal bone tumor cases to identify the most frequent patterns in diagnoses. Attention is paid to the carpal bone involved and type, and patient demographics was performed to summarize published findings.  A systematic review was searched on PubMed, Ovid, and Cochrane databases gathering literature on carpal bone tumors. After applying specific criteria, final analysis of the literature yielded 151 patients with 156 carpal bone neoplasms.  The most common carpal bones involved were the scaphoid (48, 31%), capitate (31, 20%), and hamate (24, 15%). Benign tumors represented the largest majority (133, 85%), followed by metastatic (17, 11%) and primary malignant (7, 5%). The most frequent tumor types were osteoid osteoma (37, 24%), osteoblastoma or giant cell tumor (24, 15%), intraosseous ganglia (21, 13%), and chondroblastoma (14, 9%). Within the metastatic category, most tumors derived from lung carcinoma (10, 59%), followed by renal cell carcinoma (2, 12%). There were three types within the malignant category: chondrosarcoma (3, 43%), hemangioendothelial sarcoma (3, 43%), and osteosarcoma (1, 14%).  The most frequent carpal bones observed were the scaphoid, capitate, and hamate. Most tumors were benign. The most common tumor types were osteoid osteoma, osteoblastoma, and giant cell tumor. Metastatic carpal tumors were most commonly from lung carcinoma. Chondrosarcoma and hemangioendothelial sarcoma were the most common primary malignancies.