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Bone metastases of the hand.

Abstract Introduction The aim of this study was to identify patients with malignant hand lesions, establish the proportions of those that were metastases and review their clinical course. Methods A retrospective search of a prospective tumour database was carried out to identify all patients treated at our unit with hand metastases. Patient demographics were recorded including site of primary malignancy, region of the hand involved, management of their metastasis and clinical outcome. Results Overall, 149 patients were identified with a malignant tumour of the hand. Ten had a metastatic lesion. There were 3 women and 7 men with a median age of 68 years (range: 28-91 years) at presentation. All presented with non-mechanical hand pain while four had pain and swelling. The median interval from symptom onset to diagnosis was eight weeks. The minimum follow-up duration was four months. Three patients had no history of malignancy. Of the remaining seven patients, three had other known metastases. Six patients underwent solely palliative radiotherapy. Three patients had amputation. One was treated with surgical excision and radiotherapy. One had an amputation and axillary node clearance. All but one patient had died by the time of the latest follow-up appointment. The median time to death following identification of acrometastases was 18 months. Sites of primary disease were skin (n=4), lung (n=3), kidney (n=2) and neuroendocrine system (n=1). The thumb was the most commonly affected location. Conclusions This study demonstrates that patients presenting with non-mechanical hand pain should be considered to have a malignant process until proved otherwise, particularly in patients with thumb symptoms and a history of prior malignancy.
PMID
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Authors

Mayor MeshTerms

Hand Bones

Keywords

Finger phalanges

Hand

Metacarpal bones

Metastasis

Neoplasm

Oncology

Thumb

Journal Title annals of the royal college of surgeons of england
Publication Year Start




PMID- 28853594
OWN - NLM
STAT- MEDLINE
DA  - 20170830
DCOM- 20170913
LR  - 20170913
IS  - 1478-7083 (Electronic)
IS  - 0035-8843 (Linking)
VI  - 99
IP  - 7
DP  - 2017 Sep
TI  - Bone metastases of the hand.
PG  - 563-567
LID - 10.1308/rcsann.2017.0096 [doi]
AB  - Introduction The aim of this study was to identify patients with malignant hand
      lesions, establish the proportions of those that were metastases and review their
      clinical course. Methods A retrospective search of a prospective tumour database 
      was carried out to identify all patients treated at our unit with hand
      metastases. Patient demographics were recorded including site of primary
      malignancy, region of the hand involved, management of their metastasis and
      clinical outcome. Results Overall, 149 patients were identified with a malignant 
      tumour of the hand. Ten had a metastatic lesion. There were 3 women and 7 men
      with a median age of 68 years (range: 28-91 years) at presentation. All presented
      with non-mechanical hand pain while four had pain and swelling. The median
      interval from symptom onset to diagnosis was eight weeks. The minimum follow-up
      duration was four months. Three patients had no history of malignancy. Of the
      remaining seven patients, three had other known metastases. Six patients
      underwent solely palliative radiotherapy. Three patients had amputation. One was 
      treated with surgical excision and radiotherapy. One had an amputation and
      axillary node clearance. All but one patient had died by the time of the latest
      follow-up appointment. The median time to death following identification of
      acrometastases was 18 months. Sites of primary disease were skin (n=4), lung
      (n=3), kidney (n=2) and neuroendocrine system (n=1). The thumb was the most
      commonly affected location. Conclusions This study demonstrates that patients
      presenting with non-mechanical hand pain should be considered to have a malignant
      process until proved otherwise, particularly in patients with thumb symptoms and 
      a history of prior malignancy.
FAU - Morris, G
AU  - Morris G
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Evans, S
AU  - Evans S
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Stevenson, J
AU  - Stevenson J
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Kotecha, A
AU  - Kotecha A
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Parry, M
AU  - Parry M
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Jeys, L
AU  - Jeys L
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
FAU - Grimer, R
AU  - Grimer R
AD  - Royal Orthopaedic Hospital NHS Foundation Trust , UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ann R Coll Surg Engl
JT  - Annals of the Royal College of Surgeons of England
JID - 7506860
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Amputation
MH  - Bone Neoplasms/diagnostic imaging/radiotherapy/*secondary/surgery
MH  - Female
MH  - *Hand Bones/diagnostic imaging/surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Radiography
MH  - Retrospective Studies
MH  - Thumb/surgery
OTO - NOTNLM
OT  - Finger phalanges
OT  - Hand
OT  - Metacarpal bones
OT  - Metastasis
OT  - Neoplasm
OT  - Oncology
OT  - Thumb
EDAT- 2017/08/31 06:00
MHDA- 2017/09/14 06:00
CRDT- 2017/08/31 06:00
AID - 10.1308/rcsann.2017.0096 [doi]
PST - ppublish
SO  - Ann R Coll Surg Engl. 2017 Sep;99(7):563-567. doi: 10.1308/rcsann.2017.0096.